간내 담석과 동반된 간내 담도암에서의 p53과 Ki-ras의 발현

김명환,이성구,서동완,이승규,남승우,박능화,민영일,김연석,심기남,공경엽 대한소화기학회 1997 대한소화기학회지 Vol.30 No.5

Background/Aims: Hepatolithiasis or primary intrahepatic stones may be accompanied later by intrahepatic cholangiocarcinoma. This cancerous lesion is frequently associated with atypical hyperplastic epithelium that was suspected of being precancerous. To investigate the Ki-ras or p53 mutation may play a role in carcinogenesis, and to determine whether atypical hyperplastic epithelium may be precancerous, this study was performed in intrahepatic cholangiocarcinomas associated with hepatolithiasis. Methods: We examined 12 patients with intrahepatic cholangiocarcinomas associated with hepatolithiasis. Ki-ras point mutations were assessed by direct DNA sequencing. Expressions of p53 protein were immunohistochemically assessed. The overexpression of p53 and point mutation of Ki-ras were examined in normal, hyperplastic, atypical hyperplastic, and can- cerous tissues separately. Results: The expressions of p53 protein were detected in 4 (33%) of 12 cholangiocarcinomas and Ki-ras point mutations at codon 12 were found in 2 (17%) of 12 cholangiocarcinomas. In those two carcinoma cases which contained the mutant sequence of Ki-ras, the same point mutation from wild type GGT (glycine) to GAT (aspartic acid) was. found in the associated atypical hyperplastic epithelium. However, none of the normal and hyperplastic epithelium harbored Ki-ras or p53 mutations. Conclusions: The overexpression of p53 may play a part in the carcinogenesis of some intrahepatic cholangiocarcinomas associated with hepatolithiasis, whereas the role of Ki-ras mutations in those cases is dubious. However, Ki-ras point mutation at codon 12 may be responsible for either cancer or atypical hyperplastic epithelium associated with hepatolithiasis in certain cases, suggesting atypical hyperplastic epithelium may give rise to carcinoma.

소아에서 출혈을 동반한 단일 연소성 용종의 내시경적 절제술

김준기,조상욱,신성하,고영춘,최정영,서강석,강명원,임연근,여향순,김경수 全南大醫大 2001 전남의대학술지 Vol.37 No.3

개에서 피지선 과형성의 진단 및 치료 증례

박희서,손화영,정성목,송근호,조종기,이영원,신상태,김명철,김덕환,박성준 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

An eleven year old castrated male Maltese was presented to the Veterinary Medical Teaching Hospital of Chungnam National University. In physical examination, approximately 0.5 cm round mass was observed on tail base. This small elevated mass has also shown alopecic and firm configuration. It was differentially diagnosed as sebaceous adenoma and hyperplasia by fine needle aspiration. After surgical removal, the sample was diagnosed as sebaceous hyperplasia by histopathological examination. It has not yet shown any signs of recurrence and prognosis has teen good.

지구성 운동이 중년여성의 혈중지질농도에 미치는 영향

朴麟基,崔大雨,李明秀,徐在河,趙炳俊,金泰亨 충남대학교 체육과학연구소 2000 體育科學硏究誌 Vol.18 No.1

The purpose of this study was to identify the effect of endurance exercise program on the middle-aged women. Six subjects were recruited from among volunteers responding to advertisements placed around the university community. All subjects, with no experience in regular physical activity participated in an interventional training consisting of swimming and stretching three days a week for 10weeks. Pre-and post blood lipid levels, such as Total Cholesterol(TC), High Density Lipoprotein Cholesterol(HDL-C), Low Density Lipoprotein Cholesterol(LDL-C), and Triglyceride(TG) were measured. A paired t-test showed results that were significant the .05 level were HDL-C , LDL-C, TG, and TC/HDL-C Ratio. The main finding of the study was that the role of endurance training, as prescribed in our study has the effect of making improvements in blood lipid levels for the middle-aged women. 1. After a 10week period of endurance exercise, the Total Cholesterol(TC) level was higher than that of pre-test. But the difference no showed the statistical significance. 2. After a 10week period of endurance exercise, the High Density Lipoprotein Cholesterol(HDL-C) Low Density Lipoprotein Cholesterol(LDL-C). Triglyceride(TG) level was higher than that of pre-test. and the difference showed the Statistical significance. In conclusion, even though there was significant in blood lipid levels after endurance exercise, swimming has a beneficial on improving in the middle-aged women.

비만을 동반한 위암 환자에서 두 병을 같이 수술 치료한 경험(증례)

최경현,윤기영,문형환,신연명,서경원,안수미,송윤미,석정희,정경연,이은하 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3

Obesity is growing problem in Korea. We had a case of bariatric surgery during gastric cancer operation. Patient was 29 year old Korean lady with early gastric cancer located in the lesser curvature side of the middle 1/3 of the stomach. Her body weight was 89 kg, height 163 cm, and thus body mass index was 33.5 kg/m2. Preoperative blood pressure was 130/90 mmHg, hemoglobin 12.9 g/dL, total lymphocyte count 3,280/mL, serum albumin 4.3 g/dL, CEA 1.1 ng/mL, CA 19-9 9.1 ng/mL, and alpha fetoprotein 2 ng/mL. Another associated disease was right thyroid follicular neoplasm. The chest X-ray was normal. After IM injection of 2,500 units of heparin 30 minutes before the induction of general anesthesia, she received curative subtotal gastrectomy and Roux en Y gastrojejunostomy when a malabsorption loop of 120 cm jejunum was incorporated between the Treitz ligament and the end to side jejuno-jejunostmy site at May 29th 2006. Her postoperative course was uneventful except a minor wound seroma and the elevations of serum amylase(up to 4 folds) and lipase(up to 2 folds). She lost her body weight 9 kg in 5th, 21 kg in 7th, and 27 kg in 10th postoperative months to became 61.5 kg. On follow up exams in July 2008, she gained 4 kg to overcome her weakness and fatigue. From the above result, the incorporation of a malabsorption loop during reconstruction phase of gastric cancer operation was a good option for obese gastric cancer patients especially in cases of early gastric cancer.

그레이브스 병 치료 후 재발 위험 인자에 관한 연구

이영창,유명희,윤석기,변동원,서교일,김극배 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.2

연구 배경 : 그레이브스 병에 대한 항갑상선제 치료후 적절한 치료 여부 평가 및 재발 위험성을 예측하기 위하여 여러 가지 예후 판정 인자들이 연구되어 왔으며, 이러한 인자들 중 TRH(thyrotropin-releasing hormone) 자극 시험이 가장 믿을 만한 검사중에 하나로 알려져 있다. 그러나 TRH 자극 검사가 정상으로 나와도 재발하는 경우가 많으며, 현재로는 이러한 경우에 재발을 예측하는 예후 인자에 대한 연구는 전무한 실정이다. 금번 연구에서는 TRH 자극 시험 후 TSH(thyroid stimulating hormone)가 정상적인 반응을 보인 환자를 대상으로 재발 및 관해여부를 예측할 수 있는 인자들을 찾고자 하였다. 대상 및 방법 : 항갑상선제제 치료 종료후 TRH 자극 시험을 시행하였던 그레이브스 병 환자 총 84명 중, 정상적인 TSH 반응을 보이면서 1년 이상 추적 관찰이 가능하였던 32명의 환자를 대상으로 하였다. 처음 진단 시와 치료 종료 시에 T3(triiodothyronine), T4(thyroxine), T3/T4 비, TSH, TRAb, Anti-TPO Ab(anti-thyroperoxidase antibody)를 측정하였으며, 치료 종료 2개월후에는 TRH 자극 검사를 하여 TSH 증가폭(△TSH) 및 유리 T_(3) 증가폭(△FT_(3))을 구하였다. 모든 측정치는 평균±표준편차로 표시하였으며, SPSS software를 이용하여 Student's paired t-test, chi-square test, Wilcoxon signed ranks test를 시행하였고, 유의 수준 0.05 이하를 통계적으로 유의하다고 판단하였다. 결과 1) 총 32명의 환자 중 재발한 환자(Group Ⅰ)는 22명(69%) 이었으며, 재발한 환자(Group Ⅱ)는 10명(31%) 이었다. 2) 진단 초기 총T3 치는 Ⅰ 군에서 342.0±126.2ng/dl, Ⅱ 군에서 493.0 ±142.2 ng/dl로 Ⅱ군에 비해 유의하게 증가되었다(p<0.05). 3) Anti-TPO Ab는 Ⅰ군에서 2.9±4.4, Ⅱ군에서 22.3±22.3 U/mL로 나타나 Ⅱ군에서 유의하게 증가되었다.(p<0.05) 4) 양군에서 치료 종료후 재발시 대부분의 환자가 1년 이내에 재발하였다. 5) TRH 자극· 검사후 유리 T3 증가폭 및 TSH 증가폭은 양군간에 차이가 업ㅅ었다(1.5±0.9 vs 1.2±1.0 pmol/L, 12.54±7.56 vs 11.23±4.21 mU/L, p>0.05) 결론 : TRH 자극 검사후 정상적인 TSH 반응을 보인 환자에서 재발 및 관해여부를 치료 초기 T3 및 치료 종료시 Anti-TPO Ab로 예측할 수 있었으며, 이들 측정치가 증가해 있을수록 재발의 가능성이 많음을 알 수 있었다. 또한 투약 중단후 초기 12개원의 추적기간 동안 관해가 유지되면 그 이후엔 재발의 가능성이 현저히 줄어 들었으며, 이 후 좀더 많은 환자들을 대상으로 하는 장기적인 추적연구가 진행 되어야 할 것으로 사료된다. Background : Many studies were undertaken to find parameters that could predict the clinical course of patients with Graves' disease after withdrawal of antithyroid drugs. In many parameters, TRH (thyrotropin-releasing hormone) stimulation test and T3 suppression test were considered to be one of the most reliable for predicting remission. But recently, some studies showed that the measurement of free T3 and FT3 are to be a more accurate than other thyroid function test. In this study, we measured T_(3), T_(4), T_(3)/T_(4), TSH (thyroid stimulating hormone), TRAb (TSH receptor antibody), FT3 and other known useful parameters to compare the factors influencing the relapse of Graves disease after antithyroid medication. Patients and methods : Among the 84 Graves' disease patients who had done the TRH stimulation test after withdrawal of antithyroid medication, we examined 32 patients who showed normal TSH response and followed up more than one year. T_(3), T_(4), T_(3)/T_(4), TSH and TRAb levels were measured at the time of diagnosis and at the end of therapy. Serum TSH and FT_(3) levels were measured after TRH stimulation, after two months of withdrawal of medication. Statistical evaluation was Performed by SPSS software in combination with Student's Paired t-test, chi-square test, Wlicoxon signed-ranks test. p-value less than 0.05 was considered to be significant. Results 1. In the 32 patients with Graves disease, 10 patients(31%) relapsed(Group Ⅰ) and 22 Patients(69%) remained in remission(Group Ⅱ). 2. Initial serum T3 level was significantly higher in group Ⅰ than group Ⅱ(342.0 ±126.2 vs. 493.0±142.2 ng/dl, p<0.05). 3. Anti-TPO Ab level was significantly higher in group Ⅰ than group Ⅱ(22.3±22.3 vs 2.9±4.4 U/mL, p<0.05). 4. In group Ⅰ and Ⅱ most patients showed relapse within 1 year after antithyroid medication. 5. After TRH stimulation test, serum FT_(3), and TSH level were not significantly different between group I and Ⅱ(p>0.05). 6. Serum T_(4), T_(3)/T_(4), TSH, TRAb levels were not significantly different from group Ⅰ and Ⅱ. Conclusion : In this study, we found increased relapse rate in the patients with Graves' disease whose initial serum T3 and anti-TPO Ab levels were high, so these parameters could be used to predict the relapse of Graves' disease. In the case of more than 12 months remission period after withdrawal of antithyroid medication, no relapse wsa observed in this study, but study should be done in the large population of patients with Graves' disease.

제1형 당뇨병 환자에서 췌도세포 동종이식의 반복시행

양태영,정인경,서인아,오은영,조건영,오승훈,김성주,정재훈,민용기,이명식,이문규,김광원,도영수,주성욱 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경:췌도세포 이식은 시술이 간편하고 안전하기 때문에 반복이식이 가능하여 그 동안 여러 센터에서 반복이식의 성공을 보고한 바 있다. 국내에서도 본 병원을 비롯하여 몇몇 센터에서 췌도세포 이식이 활발히 시도되고 있으나 사람에서의 동종이식 및 동종 이식의 반복시행은 보고된 바 없는 실정이다. 저자 등은 국내 최초로 췌도세포 동종이식을 시행하여, 혈청 C­펩타이드가 증가하고 인슐린 요구량이 감소하였으며, 혈당농도와 당화혈색소의 안정을 보였다. 그러나 이식 70일 후 다시 인슐린 요구량이 증가하고 C­펩타이드가 감소하여 췌도세포 이식을 다시 시행한 바 있다. 2차 이식 후 70여일이 지난 현재 다시 혈청 C­펩타이드가 증가하고, 인슐린 요구량이 더 감소되어 췌도세포 이식에서 반복 시행의 유용성을 보고하는 바이다. 방법:환자는 32세 남자로 17년전 당뇨병 진단 후 인슐린 치료 중이었으며, 3년전 부터는 만성신부전증으로 혈액툭석을 하고있었다. 1999년 12월 25일 신장이식을 하였고 3일 후 췌도이식을 하였으며, 두번째 이식은 70일 후 시행하였다. 췌도분리는 변형된 Recordi방법과 비연속성 자당 농도차(discontinuous density gradient)를 이용하였으며 분리한 췌도는 배양 후 환자의 신장기능이 정상화되고 미생물학 검사에서 음성을 확인한 후 경피경간으로 간문맥을 접근하여 16G 폴리 에틸렌 카테터를 이용하여 간실질에 이식하였다. 결과:1차 췌도이식시 순수분리전 췌도수는 210,000개, 순수분리후 획득한 췌도수는 90,000개, 순도 95%, 세포양 1.0mL 이었고, 2차 췌도이식시 순수분리전 췌도수는 420,000개, 순수분리후 획득한 췌도수는 370,000개, 순도 95%, 세포양 1.5mL 이었다. 1,2차 모두 간문맥을 통해 약 20분에 걸쳐 간실질에 주입하였다. 췌도이식전 인슐린요구량은 75∼75U/일, HbA1e 8∼10%, C­펩타이드 0.6ng/mL 였으며, 1차 췌도이식수 7일째 인슐린 요구량은 40U/일, C­펩타이드 1.5ng/mL, FPS 109mg/mL 였고, 40일 추적관찰 후 인슐린 요구량이 36U/일, C­펩타이드 1.8ng/mL, HbA1e 6.5∼7.0%로 안정되었다. 그러나 이식 50일째부터 인슐린 요구량이 50∼56U/일, C­펩타이드 0.6ng/mL, FPS 130∼200mg/dL로 혈당 조절이 불안정하여 다시 췌도이식을 시행하였다. 2차 이식후 50일이 경과한 현재, 인슐린 요구량은 26U/일, C­펩타이드 1.8ng/mL, FPS 90∼120mg/dL로 다시 안정되었다. 결론:췌도이식은 반복이식이 가능하며, 본 환자의 경우 인슐린요구량 감소, 혈당의 안정화 및 C­펩타이드가 상승하여 이식한 췌도의 기능을 확인할 수 있었고, 향후 스테로이드 등 면역억제가 유지 용량으로 감량되면 인슐린 요구량은 더 감소될 것으로 기대된다. Over the past 20 years, significant advances have been made in human islet transplantation. However, cases of prolonged insulin independence after islet allotransplantation have rarely been reported and over time, a slight, gradual decrease in insulin secretion appears to occur, as suggested by the lower C-peptide. Although preliminary clinical success achieved over the past few years has been considerably higher with whole pancreatic transplant than with isolated islet grafts, both approaches remain experimental. Islet grafts might gain, over time, increasing credibility and might eventually provide an easier alternative in terms of grafting procedures and patient management, as compared with the more "traumatizing" whole-pancreas transplantation. Also, using islet, re-transplantation is possible. But it is not known whether re-transplantation of islet could be suitable for those patients who lost grafted islet function. The aim of the present study was to investigate the benefits of re-transplantation of islet in previously simultaneous islets-kidney transplant (SIK) patient who have lost graft function. Methods : The recipient was a 32 year old male. First islet transplantation was underwent at December 25, 1999. However, the grafted islets lost function after 70 days. So we performed re-transplantation of islets. The isolation of islet was conducted sterilely on a laminarflow hood and isolated by a modified Recordimethod. The islet was injected slowly into the liver via a cannular placed in the potalvein for 20 minutes. Results : Transplanted islets were 90,000 IEq at first islet transplantation, 370,000 IEq at second islet transplantation. The insulin requirement was reduced from 75-85 to 35-40 U/day, the basal C-peptide level was 1.5 ng/mL at 7 days posttransplant Unfortunately, the grafted islets lost function after 70 days. After second transplantation, the insulin requirement was reduced to 26 U/day. Conclusions : Despite the continuous need for exogenous insulin therapy, islet transplantation can prevent wide glucose fluctuations, thus resulting in normalization of glycemic control and improvement in HbAlc, and also, show that islets can be successfully and safely re-transplanted intraportally in patients who have lost previously grafted islet function (J Kor Diabetes Asso 457~466, 2000).

식도를 포함한 전위장관을 침범한 전이성 악성 흑색종 1예

최정영,김준기,신성하,고영춘,조상욱,서강석,강명원,임연근,여향순,김경수 全南大醫大 2001 전남의대학술지 Vol.37 No.1

Characteristic Analysis and Experimental Verification of the Axially Asymmetric Structured Outer-Rotor Type Permanent Magnet Motor

Myung-Ki Seo,Tae-Yong Lee,Kyungsoo Park,Yong-Jae Kim,Sang-Yong Jung 대한전기학회 2016 Journal of Electrical Engineering & Technology Vol.11 No.4

In this study, we have dealt with a design characteristic of outer-rotor type permanent magnet (PM) motor applied for Engine Cooling Fan (ECF). When we design a motor with structure like this type, it is required as a requisite to consider 3-Dimensional (3-D) effect by implementing a non-linear Finite Element Analysis (FEA) due to a yoke-ceiling, which is perpendicular to the axis of rotation. We have analyzed identical models under three different conditions. The analysis has been performed through a non-linear 2-Dimensional (2-D) and 3-D FEA. Finally, the results have been compared with Back Electro-Motive Force (BEMF) value of actual motor model. As a result, a yokeceiling function as an additional flux path and the operating point on B-H curve of rotor material is shifted to non-saturation region relatively. Accordingly, magnetic flux linkage can be increased and motor size can be decreased under same input condition to satisfy ECF specification, such as torque.

Comparison of Hyperemic Efficacy Between Central and Peripheral Venous Adenosine Infusion for Fractional Flow Reserve Measurement

Seo, Myung-Ki,Koo, Bon-Kwon,Kim, Ji-Hyun,Shin, Dong-Ho,Yang, Han-Mo,Park, Kyung-Woo,Lee, Hae-Young,Kang, Hyun-Jae,Kim, Hyo-Soo,Oh, Byung-Hee,Park, Young-Bae Ovid Technologies Wolters Kluwer -American Heart A 2012 Circulation. Cardiovascular interventions Vol.5 No.3

<P>Maximal hyperemia is a prerequisite for the accurate measurement of fractional flow reserve (FFR). Although continuous infusion of adenosine via the femoral vein is considered to be the gold standard, this requires an additional invasive procedure for femoral vein access and is difficult to use during transradial coronary catheterization. We performed this prospective study to evaluate the feasibility and efficacy of peripheral intravenous infusion of adenosine for FFR measurement.</P>