대장암종에서 암관련 유전자들의 Promoter Methylation과 암종 발생 및 진행과의 관게에 대한 연구

정동준,이정은,민영기,조성우,백무준,양승하,김의한,김창진 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

The colorectal corcinoma is one of the most common malignant tumor in Korea and its carcinogenic mechanism has not been elucidated exactly yet. So far, the most common carcinogenic mechanism has been known to be multiple genetic changes. But, the CpG island hypermethylation has been revealed to be one of the most important carcinogenic mechanism second to the genetic changes. The epigenetic changes characteristically imprint and transfer to the next generation without changes of nucleotide sequences. When the CpG island of promoter or 5'- exon 1 of a specific gene is methylated by DNA methyltrasferases (DNMTs), the gene expression is inhibited. Carcinogenic mechansisms by promoter methylation has been well known, but the progression of the cancer has not been elucidated yet. The molecular researches on the carcinogenic mechanisms largely depended on the tumor tissue containing various components of cell, due to difficulties in harvesting pure homogeneous tumor cells. Promoter methylatonof the cancer related genes as APc, hMLH2, p16, DAP-K and MGMT in 50 cases of sporadic colorectal carcinoma was studied. The pure normal colorectal epithelial cells, and cancer cells from superficial and deep invasive portion were harvested respectively by laser captured microdissection(LCM), and DNA was extracted from them. The promoter methylation was studied by methylation specific poymerase reaction (MSP) after bisulfite modification of the DNA and the expression of the genes by immunohistochemistry. The results suggests that promoter methylation of the cancer related genes are closely related with the colorectal carcinogenesis and it occurrs from early phase of carcinogenesis, progressing constantly to the late stage. And the promoter methylation of normal epithelial cells increased by age. The p15, known to be the genes related to hematologic malignancy, was closely related to the colorectal carcinoma as well.

전신마취 후 발생한 악성고열증 환자의 치료 경험

이근무,정승환,이정한,정순호,최영균,김영재,신치만,박주열,이영민 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Malignant hyperthermia is the disorder of calcium regulation within skeletal muscle associated predominantly with anesthesia. It is triggered by volatile anesthetics and depolarizing neuromuscular blocking agents. We experienced a case of malignant hyperthermia. 50 years old female patient was transferred to our emergency room that she was developed tachyarrhythmia and high fever. She was taken arthroscopic examination under the general anesthesia with enflurane and succinylcholine. We suspected malignant hyperthermia and promptly treated her with dantrolene sodium. She was developed disseminated intravascular coagulopathy and acute renal failure then we were intensive care to her. She was discharged without sequela. We experienced successful management of malignant hyperthermia.

자궁경부 상피종양에서 human papillomavirus 감염과 survivin 발현

윤재호,정동준,이정은,박동명,배동한,선우재근,백무준,김창진 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Human papillomavirus (HPV) has been considered a causative agent of uterine cervical carcinoma. HPV is a DNA oncogenic virus, which is well known as a causative virus in uterine cervical carcinoma. The virus is classified into two groups genotypically, low risk and high risk, according to the carcinogenic potentiality, and the determination of the viral genotype is important in clinical practice. Recently, numerous genotypes can be determined by high throughput method using DNA chip. Survivin is a recently characterized inhibitor of anti-apoptosis (IAP) protein, which is abundantly expressed in most solid and hematological malignancies, but undetectable in normal adult tissues. In this study, HPV genotypes are determined by DNA chip and the expression of survivin was examined by immunohistochemistry in 80 cases of uterine cervical intraepithelial neoplasia (CIN) and invasive carcinoma to see the roles of HPV and survivin in the carciogenesis of uterine cervical epithelial neoplasia. The results were as follows: 1. HPV positive rate was 72.5%, while negative rate was 27.5% in 80 cases of CIN and invasive carcinoma. The CIN and invasive carcinoma showed higher HPV positive rate (p <0.05). 2. HPV positive rate according to the histologic grade were 60%, 65%, 77% and 90% in CINI, CINII, CINII and invasive carcinoma, respectively. HPV positive rate showed increasing tendency according to the histologic grade, though there was no statistical significance. 3. The most frequent genotype was type 16 and the next were 58, 52, 18 and 33 in order of frequency. 4. Survivin was expressed in 96.3% of CIN and invasive carcinoma. The expression rate of survivin showed no significant difference between the histologic grade of CIN and invasive carcinoma, but showed tendency of increased expression rate in invasive carcinoma. 5. Survivin was expressed in HPV positive and in HPV negative each as in 95.5% and 96.6% respectively. There was no significant difference of survivin expression between HPV positive and negative cases. The above results suggest that HPV has no effect on the regulation of survivin expresson level in the uterine cervical intraepithelial neoplasia and invasive carcinomas.

산업부산물인 Fly Ash의 라이닝콘크리트에의 적용에 관한 실험적 연구

최세진,임정열,정우성,김완영,김무한 공주대학교 자원재활용신소재지역협력센터 2000 2차년도 센터 사업 성과집 Vol.2000 No.1

This is an experimental study to analyze the usability of fly ash in the tunnel lining concrete. For this purpose, the mix proportion of plain concrete and concrete using fly ash(the replacement of 15 and 30% by weight of cement) to satisfy slump 15cm, air content 5% and compressive strength 270kgf/cm2, was selected. And then tests for slump, setting time, compressive strength, tensile strength, drying shrinkage and adiabatic temperature rise were performed. According to test results, it was found that the concrete using fly ash 15% (FA 15 concrete) was better than the plain concrete and FA 30 concrete. FA 15 concrete was more useful than the others in reducing the drying shrinkage : the drying shrinkage strains of FA 15 concrete after 20 weeks of air drying was lower about 10% than the plain concrete, and lower 6% than FA 30 concrete. And the highest compressive strength after curing for 28 days of 365kgf/cm2 was obtained from FA 15 concrete. This was almost 10-20% improvement in compressive sterngth, compare to the plain concrete and FA 30 concrete. And the effect of 5~7.5℃ of concrete using fly ash for hydration heat reducing was calculated. Therefore, concrete using fly ash 15% (FA 15) was expected to improve the performance of lining concrete.

천연골재 및 재생골재콘크리트의 Na₂SO₄침식에 의한 화학저항성에 관한 실험적 연구

김규용,이정율,박유신,강석표,김무한 忠南大學校 産業技術硏究所 1998 산업기술연구논문집 Vol.13 No.1

Now a day, the more Proportion of concrete used in practice is exposed to serious chemical attack Chemical reactions that involve formation of expansive products in hardened concrete can lead to certain harmful effects. In this study, it is to compare and investigate the chemical resistance of natural and recycled aggregate concrete by attacked Na₂SO₄according to W/C ratio. The result of this study is that the chemical resistance of recycled aggregate concrete is lower than natural aggregate concrete. But it is developed the chemical resistance by decreasing the W/C ratio.

복강경하 대장절제술을 시행 받는 환자에서 라모세트론과 온단세트론외 술 후 오심 및 구토 예방 효과 비교

김효중;어전영;어근무;어정한;엄세훈;조광래;김명훈 인제대학교 2011 仁濟醫學 Vol.32 No.-

Objectives : We evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) in laparoscopic colectomy. Methods and Materials : Eighty patients who received laparoscopic colectomy were randomly divided into two groups: R group (ramosetron 0.1mg PO) and O group (ondansetron 4mg twice IV). Injection or oral medication was administered before the induction of anesthesia in each group. Injection was administered at the end of surgery in O group. General anesthesia was induced using propofol and rocuronium, and maintained with sevoflurane, remifentanil and air (FiO2 0.5), We investigated the incidences of PONV in each group by the Rhodes index of nausea, vomiting and retching (RINVR) at postoperative 6 and 24 hours. Results : The incidence of PONV was not different between group at each time points after surgery (at postoperative 6 hours: 20% in group R, 17.5% in group 0, at postoperative 24 hours; 12.5% in group R, 7.5% in group 0). There was no difference in the severity of PONV, satisfaction, rescue drug usage. Conclusion : Prophylactic therapy with ramosetron is as effective as conventional prophylactic therapy with ondansetron for preventing PONV in general anesthesia for laparoscopic colectomy.

전기경련요법에서 remifentanil이 혈역학에 미치는 효과

정순호,이상은,임세훈,이정한,이근무,최영균,김영재,신치만 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: Electroconvulsive therapy (ECT) is often associated with transient hypertension and tachycardia. Acute hemodynamic change may produce serious complications. Remifentanil is a potent ultra short acting opioid and has been found to reduce blood pressure and heart rate. The goal of this study was to evaluate effects of remifentanil on seizure duration, recovery parameters and hemodynamic changes during ECT. Methods: Ten ASA Ⅰ, Ⅱ patients enrolled in this prospective, randomized trial, each receiving more than four electroconvulsive therapy. Patients were randomized to receive placebo, group P (propofol 1mg/kg+0.9% normal saline 1ml, n=10), and propofol with remifentanil, group R (propofol 1mg/kg+remifentanil 1ug/Kg n=10). Supplemental dose of propofol was given as required to achieve loss of consciousness. We recorded hemodynamic parameters, seizure duration, and recovery parameters. Results: Seizure duration and recovery parameters were similar in group R and group P. Blood pressure and Hear rate after ECT were significantly lower in group R. Conclusions: Remifentanil(1ug/kg) attenuated the acute hemodynamic response to ECT under propofol anesthesia without adversely affecting the duration of seizure activity and recovery profile. Adjunctive use of remifentanil may be good alternative regimens for ECT.

복식자궁전적출술과 인공슬관절 치환술 환자에서 정맥내 자가통증조절이 수술 후 진통에 미치는 효과

최영균,남현옥,이정한,이근무,정순호,김영재,신치만 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: Intravenous patient-controlled analgesia(IV PCA) is gaining wide spread popularity in the management of postoperative pain control. The purpose of this study is to evaluate the severity of pain after TAH and TKRA through comparing visual analogue scale(VAS) of pain of each patients who received identical IV PCA protocol, and to improve our IV PCA protocol. Methods: TAH group includes twenty female patients who were scheduled for TAH. TKRA group includes twenty female patients who were scheduled for TKRA. Each group received fentanyl 50㎍ about 30minutes before the end of surgery, followed by IV PCA with fentanyl 1500 ㎍, ketolorac 300mg, ondansteron 8mg, normal saline 56㎖(total 96ml, basal infusion rate 1㎖/hr, bolus dose 1㎖, lockout time 10 minutes). VAS scores were recorded at 1, 6, 12, 24, 48 hours postoperatively. Total bolus doses and patients' satisfaction were checked after the end of analgesia. Results: VAS scores of TKRA group were significantly higher than those of TAH group at 12, 24, 48 hours postoperatively. VAS scores of both group progressively decreased(P<0.05). Patients' satisfaction score showed no significant difference between two groups. Total bolus dose of TKRA group was significantly higher than that of TAH. Conclusion: The postoperative pain of TKRA was more severe than that of TAH. TKRA group needed more profound postoperative pain control than TAH group. We should consider the increase of early postoperative period analgesic doses to acquire optimal pain control of both group.

편도절제술을 받는 소아에서 수술 후 오심 및 구토에 대한 Propofol과 Ondansetron의 예방적 효과

김영재,구봉근,이정한,이근무,정순호,최영균,신치만 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: To examine the prophylactic effect of ondansetron and propofol against postoperative nausea and vomiting(PONV) in children undergoing tonsill ectomy Methods and Materials: Sixty children(aged 3-11 years) who underwent tonsillectomy received antiemetics (ondansetron group; ondansetron 0.1mg/kg, propofol group; propofol 0.5mg/kg) or not (control group) at the end of surgery. Anesthesia was induced with ketamine(1mg/kgiv) and rocuronium(0.5mg/kg) and maintained by inhalation anesthesia with 2-3vol% sevoflurane in 50% N_(2)O/O_(2). Premedication was given as atropine 0.01mg/kg iv. Ketorolac(1mg/kg) was injected for postoperative analgesia immediate after induction. They were monitored the incidence of PONV at operation room, postanesthetic care unit(PACU) and admission room. Results: No significant differences were observed in the total incidence of PONV among the groups. But ondansetron and propofol group made a difference(p<0.05) in the incidence of PONV at operation room compared with control group. Conclusion: In children undergoing tonsillectomy, ondansetron(0.1mg/kg) and propofol(0.5mg/kg) may have a prophylactic effect against PONV at operation room.

동일한 혈관 내에 발생한 이식형 약제 주입기 카테터의 위치이상

오대석,김영재,김명훈,조광래,임세훈,이정한,이근무,정순호,신치만 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

저자들은 56세 여성 환자의 왼쪽 쇄골 하 정맥에 시행한 이식형 약제주입기 카테터의 삽입 후 발생한 비정상 위치에 대한 증례를 보고하고자 한다. 카테터의 끝은 환자의 늘 어진 가슴, 체위, 신체의 움직임, 카테터의 유동성 등의 영향으로 천자된 정맥 내에서 견인되고 뒤쪽으로 이동하였다. 환자는 어떠한 증상도 호소하지 않았지만 비정상 위치의 카테터는 심각한 합병증을 유발할 수 있기 때문에 제거되었다. 따라서 시술자는 약제주입기 삽입 전에 환자의 신체 상태와 단순 흉부 촬영상을 확인하고 카테터의 비정상 위치가 발생할 수 있는 위험 징후를 알아차려야 하겠다.