동일한 환자에서 조혈모세포이식 전후의 호중구감소 기간 중 감염양상에 대한 비교연구 : 중심정맥관 관련 패혈증을 중심으로 Based on Central Venous Catheter Related Septicemia

류재호,노규태,이영석,이영호,권혁찬,김재석,김효진,이영민,박혜원,박근희 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

연구배경: 동일한 환자를 대상으로 조혈모세포이식 전 일반 병실에서의 관해유도 항암제치료 및 강화요법으로 인한 호중구감소 기간의 감염양상과 고용량 항암제치료 후 무균실에서의 조혈모세포이식 시 호중구감소 기간의 감염양상을 중심정맥관 관련 패혈증을 중심으로 비교 연구함으로써 효율적인 감염관리지침을 마련하고자 하였다. 대상 및 방법: 1999년 1월부터 2001년 7월까지 2년 7개월간 동아대학교병원 일반병실에서 악성혈액질환으로 항암제 치료를 받다가 조혈모세포이식을 시행받았던 22명을 대상으로 중심정맥관 관련 패혈증의 형태를 비교분석하였다. 결과: 대상 환자들의 일반병실과 무균실에서의 입원기간은 각각 32±13일, 33±19일, 호중구 감소기간은 15±12일, 17±18일, 호중구 감소기간의 발열 횟수는 14회, 14회로서 입원병실의 종류에 따른 차이는 없었다. 환자들의 중심정맥관 사용일수는 일반병실에서 29일(7~545일), 무균실에서 100.5일(25~606일)이었으며, 총 사용일수는 각각 1,515일, 3,250일로서 무균실에서의 중심정맥관 사용일수가 의미 있게 길었다(P=0.001). 중심정맥관 사용 일수에 대한 감염률은 각각 5.28/1,000일, 3.08/1,000일로서 일반병실에서 그 빈도가 높았으나 통계적 유의성은 보이지 않았다(P=0.141). 결론: 중심정맥관 삽입 후 일반병실에서 항암제 치료를 받던 환자가 조혈모세포이식을 위하여 무균실에 입원하는 경우, 중심정맥관을 교체하는 것이 감염관리를 위하여 바람직할 것으로 생각된다. Background: We compared the incidence of central venous catheter (CVC) related septicemia during neutropenic period in the same patient, which developed following chemotherapy for remission induction and consolidation, or hematopoietic stem cell transplantation (HSCT). Methods: We retrospectively reviewed the medical records and laboratory data of 22 patients with hematologic malignancies who received anticancer chemotherapy followed by HSCT at Dong-A University Hospital between January, 1999 and July, 2001. We investigated the duration of hospitalization, duration of neutropenic period, duration of catheterization, microbiologically documented organisms and incidence of CVC related septicemia. Results: The data in general ward (before HSCT) and laminar air flow room (after HSCT) were as follows: duration of hospitalization was 32±13 days and 33±19 days, duration of neutropenic period was 15±12 days and 17±18 days, median duration of catheterization was 29 days (7~545 days) and 100.5 days (25~606 days) (P=0.001), and incidence of CVC related septicemia was 5.28/1000 days and 3.08/1000 days, respectively. In the CVC related septicemia, the most common etiologic organism was coagulase negative staphylococcus. Conclusion: We suggest that the exchange of CVC before admission to laminar air flow room could decrease the incidence of CVC related septicemia in HSCT recipients.

V₂O-B₂O₃-PbO 유리의 전자 상자성 공명연구

노태호,전인,박영민,강재필,김성재,박현진,송승기 명지대학교 자연과학연구소 1996 자연과학논문집 Vol.14 No.-

V₂O??-B₂O₃-PbO 유리의 VO??에 관한 전자 상자성 (EPR) 스펙트럼으 연구하였으며, vanadium이온의 스핀해밀토니안 상수들을 구하였다. 유리시료안의 V₂O??양을 증가시킴에 따라 g??과 g??값은 증가하였으나 A??과 A??값은 감소하였다. 이는 V₂O??수가 증가하면 동일 평면상의 vanadium과 oxygen배위간 결합의 공유성이 증가함을 의미한다. 유리내의 vanadium 4가이온은 정방형 일그러진 8면체를 한 vanadyl착물로 존재한다. Electron Paranmagnetic Resonance(EPR) SPECTRA OF (VO)?? in V₂O??-B₂O₃-PbO glasses have been studied and spin hamiltonian paramenters of vanadium ion have been calculated. It is found that the value of g??and g?? increases while the value of A?? and A?? decreases with an increase of V₂O?? content in the glass samples, showing that the covalency in the in-plane vanadium -oxygen ligand bonds increase with increasing the concentration of V₂O??. The tetravalent vanadium ions exist as vanadyl complexes with tetragonally distorted octahedral sites in the glasses.

위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

전반적발달장애 아동 및 발달성언어장애 아동의 뇌 단일광자방출전산화단층촬영 소견에 대한 예비연구

이호분,신의진,육기환,유영훈,노경선,송동호 대한소아ㆍ청소년정신의학회 1997 소아청소년정신의학 Vol.8 No.2

기종성 방광염

인영호,유지형,성락희,정재용,노충희 인제대학교 2008 仁濟醫學 Vol.29 No.-

Emphysematous cystitis (EC) is a rare complicated lower urinary tract infection (UTI)characterized by air within the bladder wall and lumen. The disease is most common in middle-aged diabetic women. Patients with chronic UTI, indwelling urethral catheters, urinary tract outlet obstruction or neurogenic bladders are predisposed to complicated UTI such as EC. Most patients can be managed by adequate bladder drainage and appropriate antibiotics coverage and operation is needed very rarely. We report a diabetic women with EC who underwent partial cystectomy.

MgB₄O7 熱螢光體의 특성과 低에너지 X線의 線量測定

김영국,손인호,설정식,채건식,노경석 慶南大學校 附設 基礎科學硏究所 1997 硏究論文集 Vol.11 No.-

To develope the thermoluminescent radiation sensors and low energy X-ray of dosimetry. The TL phosphors of MgB₄O7 are prepared and their physical characteristics are investigated. MgB₄O7 : Tb. Tm. Dy. La. Ho. and Nd phosphors have been prepared by sintering around 580℃ for 2 hours followed by flowing Ar gas. Ar gas. Activation energy and kinetic order of main peak of glow curve were studied by two methods peak shape method and initial rise method. By these methods, the estimated activation energies were 0.76±0.02eV(Tb doped). 0.94±0.03(Tm doped). 0.72±0.02 (Dy doped). respectively. The activation energy frequency factor and kinetic order of thermoluminescent process for each TL phosphors are measured by analyzing the glow curve by initial rise. peak shape. different heating rate. isothermal decay method. And The emission spectra of TL phosphors are also measured. The TL phosphors prepared in this work may be utilized to radiation sensor elements becaue of their high sensitivity to low energy X-ray.

수종 한약재가 백혈병 세포에 미치는 영향에 대한 연구

崔湖榮,金澤,柳志昌,卞德市,盧昇鉉 대한본초학회 1999 大韓本草學會誌 Vol.14 No.1

I am reporting here a syntematic in vitro examination for specificity of anti-cancer effect of several oriental herbs, which have been used frequently for cancer pateints(therapy), on Molt-4 LCL(Lymphoblastoid Cell Line) Leukemic cells in relation to its density and time of incubation. 1. ErOH extract of Jujubae Fructus reduced Molt-4 cell's survival rate effectively after 48 hours' treatment at 1000㎍/㎖'s density and it reduced survival rate of LCL effectively after 12 hours' treatment at 1000㎍/㎖'s density. 2. EtOH extract of Cordyceps reduced LCL's survival rate effectively after 36 hour's treatment at 1000㎍/㎖'s density. 2. EtOH extract of Fici Fructus reduced LCL's survival rate effectively after 36 hours' treatment at 1000㎍/㎖'s density. 4. EtOH extract of Trionycis reduced Molt-4 cell's survival rate even at 500㎍/㎖ density and further effective at 1000㎍/㎖ density after 24 hours treatment and it killed the cells completely at 1000㎍/㎖ density after 48 hours treatment, It also Killed LCL completely after 12 hours and 36 hours' treatment at 1000㎍/㎖'s density. 5. EtOH extract of Biotae Cacumen reduced LCL's survival rate effectively after 12 hours' treatment at 1000㎍/㎖'s density, and after 36 hours treatment it reduced LCL's survival time very effectively. 6. EtOH extract of Psoraleae Fructus reduced Molt-4 cell's survival rate very effectively after 24 hours' treatment at 500㎍/㎖ and 1000㎍/㎖'s density, and after 48 hours' treatment at 250㎍/㎖'s density it reduced effectively and it killed the cell completely at 500㎍/㎖ and 1000㎍/㎖'s density. It also killed LCL completely after 12 hours and 36 hours' treatment at 1000㎍/㎖'s density. I hope to proceed with more advanced experiment in vivo and clinically as for the two kinds of oriental herbs and another herbs effective for leukemia.

악관절 강직증의 치험례

현영옥,강창희,노양호,천영두,김신헌,이희원 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.1

Temporomandibular ankylosis is defined as a situation in which the condyle is fused to the fossa by bone or fibrous tissue. Conditons such as trauma, infection, or systemic disease may predispose to various types of ankylosis, bringing about different levels of limitation in mandibular movement. Most patients with temporomandibular ankylosis are associated with limitation of maximal mouth opening, deviation of the chin toward the affected side, impaired occlusion, chronic pain, compromised oral hygiene, severe facial asymmetry & impeded mandibular molar eruption occurring in childhood. Several techniques to release ankylosis have been described in the literature, showing variable and often unsatisfactory results. The most frequently used operations are gap arthroplasty, interpositional arthroplasty, and exicision and joint reconstruction with autogenous or alloplastic materials. We have managed the two patients of TMJ ankylosis. They had previously TMJ surgery and we treated with gap arthroplasty & active physial therapy. We have obtained favorable results and report these cases with literatures review.

CLOSED LOCK 증례에 대한 악관절 세정술의 임상적 연구

현영옥,강창희,노양호,천영두,이희원 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.1

Purpose : To evaluate the efficacy of arthrocentesis for treatment of closed lock. Material : 42 patients were diagnosed to closed lock by physical, radiographic examriation and undergone arthrocentesis. All patients have a pain and mouth opening limitation on affected site. Method : Arthrocentesis was done under conscious sedation and local infiltration anesthesia, normal saline and some steroid was injected on upper compartment of tempormandibular joint. After pumping and lavage, manual reduction procedure of anterially displaced disc was done. All the patients wear an anterior repositioning splint just after arthrocentesis. The result of arthrocentesis was assessed by pain and difference of mouth opening. Result : Difference of mouth opening after arthrocentesis was improved to 18.85mm and pain was gradually decreased. All patients were worn stabilization type splint after mean 1.84 months. 6 patients had relapse of mouth opening limitation so done arthrocentesis again and delivered good results.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.