자궁경부상피내종양의 치료에서 환상투열요법 (LLETZ) 시행 후 잔류병변의 예측인자

김용범,박노현,이철민,김재원,송용상,강순범,이효표,김성일,심순섭 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.3

목적: LLETZ(Large loop excision of transformation zone)는 자궁경부상피내종양(CIN)의 정확한 진단목적 뿐만 아니라 치료목적으로도 사용되고 있다. 그러나 LLETZ 후 자궁경부내 잔류병변의 가능성 및 예측인자에 대하여 명확히 밝혀져 있지 않기 때문에, CIN 치료 방법으로서 LLETZ의 안정성, LLETZ 시술 후 어떤 경우에 자궁절제술 등의 추가 치료를 실시할 것인가에 대하여 논란이 있다. 따라서 본 연구에서는 LLETZ시술 후 잔류병변 여부를 예측할 수 있는 관련인자들을 확인하고 절단면 양성의 임상적 의의를 알아보고자 하였다. 연구방법: 1993년 8월부터 1995년 7월까지 서울대학교 산부인과에서 LLETZ 시행 후 자궁절제술을 시행한 133명을 대상으로 임상기록을 검토하였다. 잔류병변 양성이란 자궁절제술 후 최종병리학적 소견에서 CIN이나 침윤암 등의 잔류병변이 확인된 경우로 정의하였고, 잔류병변이 없는 경우를 LLETZ를 통한 치료에 성공한 것으로 하였다. 잔류병변의 존재 여부에 연령, 병변의 등급, 절단면의 상태 등의 인자들이 관여하는지 확인하였으며, 통계학적 분석 방법으로 Student t-test, χ2 test와 Fisher's exact test를 사용하였다. 결과: LLETZ 후 자궁절제술을 시행한 환자의 85.7%(114/133)에서는 잔류병변이 없었으나 14.3%(19/133)에서 잔류병변이 발견되었고 이 중 미세침윤암이 3례에서 확인되었다. 잔류병변이 없는 환자군의 평균연령은 42.5세(27-71세)인 반면 잔류병변이 있는 환자군의 평균연령은 49.1세(33-72)로서 유의하게 높았다(p=0.005). LLETZ 후 조직검사에서 절단면 음성인 군에서 잔류병변이 발견된 경우는 9.6%(9/94)이었고 절단면 양성인 군에서 잔류병변이 발견된 경우는 25.6%(10/39)로서 두 군간에 유의한 차이를 보였다(p=0.032). LLETZ 후 조직검사에서 CIN II인 군과 CIN III인 군에서 잔류병변이 발견된 경우는 두 군에서 모두 14.3%(2/14, 17/119)로서 두 군간에 차이가 없었다. 결론: LLETZ 후 절단면 양성 여부가 잔류병변의 존재 여부와 일치하지 않는 경우가 많으며, 폐경 이후의 연령이 많은 여성이나, 절단면 양성인 경우 등 잔류병변 양성 가능성이 높은 환자의 경우에는 보다 철저한 추적관찰 혹은 광범위 원추생검술이나 자궁절제술 등의 보다 적극적인 치료가 고려되어야 할 것으로 사료된다. Objective: Large loop excision of transformation zone(LLETZ) is gaining popularity as an alternative to other ablative or cone methods for the treatment of cervical intraepithelial neoplasia(CIN). The optimal management of CIN after LLETZ, however, remains controversial and the reliable predictors of residual disease after LLETZ have not been consistently identified. This study was performed to identify factors to predict residual disease after LLETZ. Methods: From August 1993 to July 1995, 133 patients who received subsequent hysterectomy after LLETZ in Department of Obstetrics and Gynecology at Seoul National University Hospital were retrospectively reviewed. Residual disease was defined as positive findings of CIN or further advanced findings in hysterectomy specimen. The age of patients, the severity of disease and the status of resection margin(RM) were analyzed for predictive values of residual disease. The Chi-square test, Fisher's exact test and Student t-test were used for statistical analysis. Results: The residual disease after hysterectomy was negative in 85.7%(114/133) and positive in 14.3%(19/133). Among 19 cases with positive residual disease, 3 cases were revealed to be microinvasive cervical cancer. The mean age of patients with no residual disease was 42.5 years(range; 27-71) and that of patients with residual disease was 49.1 years(range; 33-72). Nine out of 94 cases(9.6%) with negative RM and 10 out of 39 cases(25.6%) with positive RM in LLETZ had residual disease. Two out of 14 cases(14.3%) with CIN II and 17 out of 119 cases(14.3%) with CIN III in LLETZ had residual disease. The success of LLETZ which means no residual disease was influenced by the age of patients(p=0.005) and the status of resection margin of LLETZ(p=0.032). Conclusion: The negative resection margin in LLETZ does not always guarantee that there is no residual disease. Close preoperative workup and more aggressive treatment plan(wide conization or hysterectomy) should be considered in patients who has higher possibility of positive residual disease such as old age and positive resection margin in LLETZ.

복합 관동맥병변에서의 Rotational Atherectomy : 초기결과

김진우,박성욱,홍명기,이상곤,이일수,이철환,최기준,강덕현,송재관,김재중,박승정 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

뇌졸중 후 치매환자에서 도네피질(아리셉트^(?))이 인지기능 및 일상생활 수행능력, 삶의 질에 미치는 효과

이상열,장혁,송재은,조성옥,류정미,이미경,조진호,신용일 圓光大學校 醫科學硏究所 2008 圓光醫科學 Vol.23 No.1

Background: This study evaluated the efficacy of administering Donepezil(Aricept^(?)) for improving cognitive function, activities of daily living, and quality of life in patients with post-stroke dementia. Methods: Patients(n=99; mean age, 69.89 years; 48.5% men) with post-stroke dementia, according to criteria of the DSM-IV and MRI, were treated with donepezil 5mg/day or 10mg/day during 24 weeks. They were examined using Mini-mental Status Examination(MMSE), Chinical Dementia Rating(CDR), Barthel Activities of daily living(B-ADL), Instrumental Activities of daily living(I-ADL), Short Form 36 Health Survey-Korean(SF-36-K), and Geriatric Depression Scale(GDS) at before treatment and 24 weeks after treatment. Results: The 97 patients completed the trial. At 24 weeks, they showed significant improvement in MMSE(p<0.001), CDR(p<0.001), B-ADL(p=0.002), I-ADL(p<0.001), and SF-36-K(p=0.003) except GDS(p=0.288). Donepezil was well tolerated. There was no withdrawal due to adverse events. Conclusion: This results demonstrate that donepezil was beneficial in improving the cognitive function, activities of daily living, and quality of life in patients with post-stroke dementia and was well toleraetd.

효율적인 군 전직지원체제 정립 방안

정철영,고재관,황원채,윤희철,박가열,김재호,이성식,김동승,표성일,이건남,양안나,최수정,김은석 한국직업능력개발원 2008 직업능력개발연구 Vol.11 No.1

이 연구의 목적은 제대군인에 대한 효율적인 전직지원을 위해서 현행 전직지원 프로세스에 대한 개선 안과 이에 따른 국방부, 국가보훈처 등 제대군인 전직지원관련 기관 간의 역할분담 및 연계방안에 대해서 제안하는 것이다. 연구는 크게 세 가지 과정을 거쳤다. 첫째, 국내 군 전직지원 실태를 분석하여 문제점과 시사점을 도출하였다. 둘째, 이러한 문제점과 시사점, 군 전직지원 선행연구를 종합하여 효율적인 군 전직지원 프로세스 안을 제시하였다. 셋째, 구축한 군 전직지원 프로세스 안에 따라 주요 군 전직지원 관련 기관인 국방부, 국가보훈처의 역할 분담 안을 제안하였다. This study aims to suggest an improvement plan for the support process of effective occupation change for discharged soldiers and then role assignments among related institutions for supporting discharged soldiers such as Ministry of Defense, Ministry of Patriots and Veterans Affairs, Ministry of Labor and the cooperation plan among the institutions. The study was made in three steps. First, after analyzing currents support facts and status for discharged soldiers, it induced its problems and implications. Second, integrating the findings of previous studies related to support plan on occupation changes for the discharged soldiers, Problems and implications mentioned above, it constructed effective occupation change process for discharged soldiers. Then, according to the established process, it suggested role assignments such as Ministry of Defense, Ministry of Patriots and Veterans Affairs, Ministry of Labor.

성장기 흰쥐에서 단백질 장기간 알코올 투여가 인슐린 분비능 및 감수성에 미치는 영향

윤용석,허갑범,이현철,임승길,김경래,송영득,안철우,차봉수,이해일,성제경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.1

Background: This investigation was performed to examine the combined effects of protein malnutrition and chronic moderate amount of alcohol intake on insulin secretory capacity and sensitivity in growing rats. Methods: Weanling 4-week-old male Sprague-Dawley rats were fed low protein [5%, (wt/wt)] or control (C, 20%) diet from 4 to 12 weeks and alcohol (5 g/kg/d) or saline gavage from 8 to 12 weeks. All rats were divided into the 4 groups according to different diet protocols: group I (protein-deficient alcohol rats), group II (protein-deficient saline rats), group III (protein-sufficient alcohol rats), and group IV (protein-sufficient saline or control rats). At the age of 12 weeks, we determined the insulin secretory capacity and sensitivity in the 4 different diet groups. Results: The results are summarized as following; 1. Normal weight gain was nearly completely arrested in protein-deficient rats compared to control rats. In protein-sufficient rats, chronic alcohol intake decreased body weight gain. Pancreatic weight adjusted with body weight was not different among the 4 groups, but epididymal fat weight adjusted with body weight was decreased in group II compared to group IV. 2. Intraperitoneal glucose tolerance was improved in group I compared to the other groups. Insulin responses to glucose challenge were markedly decreased in group II compared to group IV, but not in group I. 3. Glucose disposal rate during euglycemic clamp test was diminished in group II compared to group IV, but there were no differences between group I and group IV. Glycogen synthase activities of skeletal muscle after 2 hour hyperinsulinemic state were not different among the 4 groups. 4. There were no differences of reserved insulin content of whole pancreas adjusted with pancreas weight among the 4 groups. 5. In light microscopic findings of pancreatic islets, sizes of islets, islet cells and nuclei were decreased in protein-deficient rats compared to control rats. However, the sizes of islet cells and nuclei were further decreased in group II compared to group I. Conclusion: These results suggest that impaired insulin secretion and decreased insulin sensitivity due to protein malnutrition can be restored by chronic, moderate amount of alcohol intake, but these beneficial effects may not be appeared in protein-sufficient state. Therefore, the chronic alcohol intake differently influences glucose metabolism according to individual nutritional status, and further studies for the effects of alcohol intake in lean diabetic patients are required to extrapolate these results in human.

Effect of TaC-Coated Crucible on SiC Single Crystal Growth

Lee, Doe Hyung,Lee, Hee Tae,Bae, Byung Joong,Lee, Hee Jun,Lee, Sang II,Park, Mi Seon,Lee, Won Jae,Yeo, Im Gyu,Eun, Tai Hee,Chun, Myong Chuel Trans Tech Publications, Ltd. 2014 Materials science forum Vol.778 No.-

<P>The present research was focused to extensively investigate the effect of TaC-coated crucible on the SiC crystal growth and then compare the difference of various properties between SiC crystals grown in conventional graphite crucible and TaC-coated crucible. The bulk growth was conducted around 2200°C of the growth temperature and 40 mbar of an argon atmosphere for the growth pressure. The better crystalline quality was obtained from the crystal grown in TaC-coated crucible. The SiC crystal grown in the TaC-coated crucible exhibited superior characteristics than SiC crystal grown in the conventional crucible in terms of the crystal quality and defect density. Furthermore, nitrogen incorporation in SiC crystal grown in the TaC-coated crucible was definitely decreased.</P>

Improved spinal fusion efficacy by long-term delivery of bone morphogenetic protein-2 in a rabbit model

Lee, Jae-Wook,Lee, Saehyoung,Lee, Sun Hwa,Yang, Hee Seok,Im, Gun-II,Kim, Chang-Sung,Park, Jung-Ho,Kim, Byung Soo Informa Healthcare 2011 Acta orthopaedica Vol.82 No.6

<P><B>Background and purpose</B></P><P> Various new delivery systems for recombinant human bone morphogenetic protein-2 (rhBMP-2) have been introduced to improve its efficacy in osteogenesis. Of these, we have previously developed heparin-conjugated PLGA nanospheres (HCPN) as a long-term delivery system for BMP-2. In vitro studies have shown that the BMP-2 long-term delivery system enhances the level of bone formation. However, the long-term effects of BMP-2 on spinal fusion have not been assessed. Therefore, we now tested the hypothesis that the long-term delivery of BMP-2 using HCPN improves spinal fusion compared to short-term delivery in a rabbit fusion model.</P><P><B>Methods</B></P><P> 24 adult New Zealand White rabbits underwent posterolateral fusion (6 animals in 4 groups). The autograft group received an autologous iliac chip bone graft as a positive control. The BMP-2-PN group received rhBMP-2 (20 μg per implant) and PLGA nanospheres (PN) suspended in fibrin gel, and served as a short-term release group. The HCPN group received HCPN suspended in fibrin gel without BMP-2 as a negative control. The BMP-2-HCPN group received rhBMP-2 (20 μg per implant)-bound HCPN suspended in fibrin gel and served as a long-term release group. All animals were killed 12 weeks after surgery. Manual palpation, axial tensile tests, radiography, and histological evaluations were then performed.</P><P><B>Results</B></P><P> The spinal fusion rate and Young's modulus of the fusion mass were better in the BMP-2 long-term delivery group than in the short-term delivery group at an equivalent dose. However, the outcome of the long-term delivery was inferior to that of the autograft group.</P><P><B>Interpretation</B></P><P> The HCPN system showed potential as an effective carrier that might improve the osteogenic efficacy of BMP-2 for spinal fusion.</P>

연골혼합성 섬유종 ( Chondromyxoid Fibroma ) 에서 발생한 종양성 골연화증 1 예

이광우,서정필,이교영,손호영,차봉연,강성구,오기원,이원영,박정미,우영균,이승구,이태규,강무일,장재혁 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.4

Oncogenic osteomalacia is a rare clinicopathological condition. The syndrome is characterized by hypophosphataemic osteomalacia with hyperphosphaturia, low plasma 1,25-dihydroxyvitamin D and normal plasma calcaemia and parathyroid hormone, associated with a tumor, generally of mesenchymal origin. Complete excision of the tumour results in cure of the whole syndrome. Recently we experienced 56-year-old woman with oncogenic osteomalacia caused by a chondromyxoid fibroma of the left foot. We report this case with the review of literatures (J Kor Soc Endocrinol 14:764-770, 1999).

Proteomic Analysis of Term Placenta Derived from Cloned Cat Embryos

Jae-II Bang,Dong-Won Bae,Young-Sang Kwon,Hyo-Sang Lee,Xian-Feng Yu,Gautam Kumar Deb,Su-Jin Cho,Eu-Gene Choi,Tae-Hyeon Kwon,Byung-Hyun Choi,II-Keun Kong 한국동물생명공학회(구 한국동물번식학회) 2009 Reproductive & developmental biology Vol.33 No.2

Proteomic Analysis of Term Placenta Derived from Cloned Cat Embryos

Jae-II Bang,Dong-Won Bae,Young-Sang Kwon,Hyo-Sang Lee,Xian-Feng Yu,Gautam Kumar Deb,Su-Jin Cho,Eu-Gene Choi,Tae-Hyeon Kwon,Byung-Hyun Choi,II-Keun Kong 한국동물번식학회 2009 Reproductive & Developmental Biology(Supplement) Vol.33 No.2s