늑골에 발생한 형질세포성 육아종 -1례 보고-

김송명,이호연,Kim, Song-Myung,Lee, Ho-Youn 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.4

Most cases of plasma-cell granuloma occur in adult skeleton system. They usually present as a single lesion, but multiple lesions are not uncommon. Roentgenographically, the lesions are lytic, sclerotic or mixed, but in the majority there is some degree of sclerosis. No specific etiologic agent is known, but it is postulated that the reaction may be associated with a variety of organisms of low-grade virulence. Certain organisms have long been known to produce predominantly plasmacytic infiltrate, notably spirochetes, mycobacteria and some exotic viruses. It is most important, however, that this entity, plasma-cell granuloma, be distinguished from multiple myeloma so those potentially life-threatening chemotherapeutic agents are not prescribed. Histologically, aggregates of chronic inflammatory cells are intermingled with the meets of plasma cells, and note the markedly thickened bone trabeculae in surrounding bone. We experienced a case of plasma-cell granuloma of right 7th. rib, occurring in 32 year old male and reported it with review of literatures.

Subclavian artery 의 동맥류 -1예 수술 경험-

이성행,이성구,한승세,이길노,김송명,Lee, Sung Haing,Lee, Sung Koo,Han, Sung Sae,Lee, Khil Rho,Kim, Song Myung 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

환자는 남자 33세이며 외상으로 인하여 좌측쇄골하동맥에 낭형의 가성동맥류가 발생했고 수술은 동맥류낭을 부분절제하고 Dacron 인조혈관을 이식하였다. 술후경과는 비교적 양호하였으며 관계된 문헌의 고찰과 함께 보고 하였다. A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

선천성(先天性) 심장병(心臟病)의 개심술(開心術) -6례(例) 수술경험(手術經驗) -

이성행,이성구,한승세,이길노,김송명,이광숙,이종국,Lee, Sung Haing,Lee, Sung Koo,Han, Sung Sae,Lee, Kihl Rho,Kim, Song Myung,Lee, Kwang Sook,Lee, Chong Kook 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2

Six cases of congenital heart disease were operated on by means of cardiopulmonary bypass between December, 1975 and April, 1976. Two cases of ventricular septal defects (VSD), two cases of VSD, associated with ruptured aneurysm of sinus Valsalva, two cases of atrial septal defects (ASD) and one case of pulmonic stenosis with patent ductus arteriosus were operated. Sarns roller pumps and Bentley Temptrol oxygenators were used for extracorporeal circulation. Pump oxygenator was primed with Ringer's lactate solution, 5% dextrose in water, mannitol, and ACD blood. Flow rate ranged from 2.0 to $2.4L/M^2/min$. Bicarbonate was added to the oxygenator with estimated amount as 15 mEq/L/hr. Venous catheters were introduced into superior and inferior vena cava, and oxygenated blood was returned to the body through aortic cannula inserted into ascending aorta. Moderate hypothermia ($30^{\circ}C$) was induced by core cooling. Aorta was cross clamped for 15 minutes and released for 3 minutes, and repeated clamping when necessary. Atrial and ventricular septal efects were closed by direct sutures. Aneurysms of sinus Valsalva ruptured into the right ventricle were repaired through right ventriculotomy by d:rect closure with Dacron patch reinforcement. Cardiopulmonary bypass time varied from 66 to 209 minutes, and aorta cross clamping time ranged from 13 to 56 minutes. Postoperative bleeding was minimal except one case who needed for evacuation of substernal hematoma. Intra- and postoperative urinary output was satisfactory. Acid-base balance, partial pressure of $O_2$, electrolytes, and hematological changes during intra- and post-perfusion period remained at the acceptable ranges. No mortality was experienced.

폐암 환자와 폐암 세포주를 주입한 Nude Mice에서 종양성장인자의 변화

김상범,박성달,김송명,허방 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.1

Background and purpose : The incidence of non-small cell lung cancer has decreased than past decades but the prevalence rate of squamous cell carcinoma is highest among the various types of lung cancer. There have been one of the most difficult problems of the medical areas because of the law rate of operative treatment by micrometastasis still. The released growth regulating factors from the tumor cells have heen researching targets recently. This study is to know the changes of the tumor growth factors by examining the change of transforming growth factor-β1 (TGF-β1) within plasma of nude mouse was measured after each of different quantity of cultured cell of squamous cell carcinoma was injected into plerual caviry of nude mouse in animal experiment, while comparing the values of TGF, Insulin-like growth factor and epidermal growth factor between experimental trial and clinical trial. Method : Between June of 2006 and June of 2007 at Kosin University Hospital, 17 patients were chosen for this study where 13 of them were pathologically diagnosed of squamous cell carcinoma after initial diagnosis of lung cancer followed by radical pneumonectomy and pathologic biopsy, while 4 patients were pathologically diagnosed of benign tumor. Blood sample was collected prior to a surgery from the lung cancer patients scheduled for surgery, and the sample was cryopreserved. During surgery, dense tumor tissue without necrosis was excised in a size of 5mm3 and quickly frozen to be used for experimental tissue, whereas the tissue, which was located farthest from the lesion and deemed free of cancer cell, was to be used for control tissue. And the tissue obtained from benign tumor or normal tissue of granuloma patient was classified as a control tissue B, while the sample from malignant tissue of lung cancer was categorized as experimental tissue M. In animal experiment with 15 male nude mice without immunity, 5 subjects without cancer cell were used for control group, another 5 subjects with of 2×106 of cancer cell line (SW-900 G IV) injected into intrathoracic were used for experimental group I, and the other 5 subjects injected with twice quantity of cancer cell line of group I were classified as experimental group II. After breeding the subjects in the clean room for 8 weeks, blood sample was collected from their heart, and quantitative test of plasma TGF-β was performed. For the test of tumor growth factor, human TGF-β ELISA kit was used for quantitation of TGF-β1&2, and active TM non-eztraction IGF kit was for quantitation of IGF-I&II, while GE healthcare kit was used for EGF. Results : In animal experiment, TGF-β1 was expressed within the serum of all nude mice from control group as well experimental group I and II, where control group was at 28.49 fmol/ml while experimental group I and II were at 32.19 fmol/ml and 42.36 fmol/ml respectively. In clinical trial, TGF-β1 was measured higher from experimental group with 40.9 fmol/ml than from control group with 28.5 fmol/ml, and TGF-β2 was lower from experimental group with 12.3 fmol/ml than from control group with 30.3 fmol/ml, while the difference was insignificant with EGF (p<0.05) where control group and experimental group were at 0.11 ng.ml and 0.12 ng/ml respectively. Moreover, TGF-β1 was at 40.88 fmol/ml from control tissue B and at 15.55 fmol/ml from experimental tissue M, where as TGF-β2 was at 12.31 fmol/ml from control tissue B and 23.95 fmol/ml from experimental tissue M (p<0.05). TGF-β1 within the serum of control group was at 812.4 fmol/ml before surgery and at 989.1 fmol/ml after surgery, which showed a slight amplifiction, while TGF-β2 was at 16.8 fmol/ml before surgery and at 20.2 fmol/ml after surgery, exhibiting a slight increase (p<0.05). Serum IGF-I was at 117.9 ng/ml before surgery and at 214.4 ng/ml after surgery, and IGF-II was at 552.8 ng/ml and 552.8 ng/ml after surgery, while EGF showed insignificant changes between before surgery at 0.67 ng/ml and after surgery at 0.74 ng/ml (p<0.05). In lung cancer stage Ia,b, TGF-β1 was decreased through surgery as it was at 972.94 mol/ml before and 866.92 mol/ml after, and TGF-β2 was also decreased as measured at 42.40 mol/ml before surgery and 38.24 mol/ml after surgery. In stage IIIa,b, TGF-β1 was decreased as measured at 980.31 mol/ml before surgery and at 928.18 mol/ml, while TGF-β2 showed not much changes (p<0.05). In lung cancer stage Ia,b, serum IGF-I was decreased as measured at 112.7 mol/ml before surgery and at 87.92 mol/ml after surgery. and IGF-II was also decreased as measured 468.78 ng/ml before surgery and at 358.59 ng/ml after surgery (p<0.05). In stage III,b, IGF-I showed not much changes, but IGF-II was at 438.31 ng/ml before surgery and 404.2 ng/ml after surgery, where EGF was not all influenced by the phase. Conclusion : In the experiment with nude mice, TGF-β1 was increased as the number of cancer cell was increased after injection of cancer cell. The number of cancer cell from early tumor, such as Ia,b from post-surgery clinical lung cancer patients, was reduced after the surgery, and TGF-β1 was also reduced as the cancer cell was reduced as well. Therefore, it was believed that TGF-β1 can be a feasible prognostic factor for early diagnosis of lung cancer at Ia,b of early phase

폐암환자의 객담에서 Melanoma Antigen Gene(MAGE)과 Synovial Sarcoma on X chromosome (SSX)의 발현

정언섭,김송명,김종인 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

Background : MAGE and SSX genes have been recently discovered as number of cancer/testis antigen, which are showed useful potential for anti-tumor immunotherapy and tumor mark. Expression rates of MAGE genes are disclosed in many cancer cases. Study of expression rate of MAGE and SSX genes in same time in lung cancer cases are rare. We studied about expression of both genes in sputum of lung cancer patients simultaneously. Material and method :Total 75 cases of patients studied, control group was 32 cases of benign lung disease, 43 cases of lung cancer patients were divided into two groups of non small cell lung cancer and small cell lung cancer groups. Patients sputum collected before treatment and extracted mRNA and identify MAGE genes and SSX genes by nested PCR method. Expression rates of both genes werestudied according to cell types, gender, LN metastasis and cancer stage. Results : In benign lung disease cases, expression rates of MAGE and SSX genes were 40.6% and 37.5% respectively. and was 12.5% in both genes. The expression rate of MAGE genes is higher inmale patients and expression rate of SSX genes is higher in female patients ( p < 0.01 ). Expression rate of MAGE genes in NSCLC group was 61.8%, and this is higher than that of control group. In squamous carcinoma, expression rate of MAGE genes is 76.9% and this is higher than that of adenocarcinoma. Expression rate in adenocarcinomaand small cell cancer are lower than control and squamous cell cancer.Expression rate of SSX genes in NSCLC group is 17.6% and is 11.1% in SCLC group. It is lower than that of control group. Expression rate of SSX genes is lower than MAGE genes in lung cancer cases and not found any relationship of expression of between both genes. No significant gene expressions between gender was observed. The present study suspect lymphnode involvement and cancer stage influence on expression of both genes in this study, but not significant statistically. Co-expression rate of both genes are 14.7% in NSCLC group, 11.1% in SCLC group and 12.5% in control group. Conclusion : MAGE genes are more applicable to diagnosing squamous cell cancer than SSX genes, but it's role seems to be still lim-ted to additive as a mark, because of expression in benign lung disease cases and lower expression rate in small cell carcinoma and adenocarcinoma. Not found any relationship on both gene expression in this study.

흉부 수술 환자에서 산, 염기와 호기말 탄산가스 분압의 변화

김종인,김송명 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

Introduction Surgical intervention is often required for treating cardiopulmonary, esophageal and mediasternal diseases. During thoracic surgery, which often involves relatively long operation time, frequent arterial blood gas analysis and continuous carbon dioxide monitoring by capnometer are mandatory. We conducted pre- and postoperative arterial blood gas analyisis and monitored the end-expiratory carbon dioxide partial pressure to investigate their relationship with operation. Materials & Method We retrospectively analyze the medical records of 115 patients, who received thoracic surgery under general anesthesia at the Kosin Medical Center from November 1998 to February 2001. Patients records of arterial blood gas analysis measured pre- and postoperatively, and end-expiratory carbon dioxide tension were monitored during operation and investigated and analyzed. Results 1) Although the postoperative arterial blood showed increased oxygen partial pressure, the oxygen saturation were similar. These results were analysed by the op time, op method. 2) Arterial blood gas analysis showed that the post-operatively measured pH, and carbon dioxide tension were higher compared to preoperative measurements. 3) The end-expiratory carbon dioxide tension measured intra-operatively showed gradually decreasing pattern with respect to operation time. As the operation time reached 240 minutes, it started to increase. 4) The end-expiratory carbon dioxide tension in relatively older age group maintained the level of above 30mmHg until 90 minutes after operation. However, the carbon dioxide partial pressure began to show decreasing pattern after 120 minutes, and thereby, caused low level of carbon dioxide tension. Thus, a special attention should be paid at this point. 5) For lung cancer,esophageal cancer and non-cancer related thoracic disease groups, the end-expiratory carbon dioxide tension was maintained at above 30mmHg until 60 minutes after operation. However, after 90 minutes, esophageal disease group showed increasing end-expiratory carbon dioxide tension, while non-cancer related thoracic disease group showed decreasing pattern. 6) The end-expiratory carbon dioxide tension in patients undergoing lobectomy and esophageal surgery showed decreasing pattern until 60 and 90 minutes, and increasing pattern is largely influenced by a position change during operation. Conclusion Prior to surgery, acidosis requires proper treatment and oxygen supply. However, since there is high level of oxygen and increased carbon-dioxide tension, adequate treatment is required. There was no significant change in the oxygen saturation level. Especially, treatment is required for acidosis and increased carbon dioxide gas after esophageal surgery. Since the end-expiratory carbon dioxide tension shows increased level at post-operative 90 minutes and decreased level at 120 minutes, special attention should be paid at these times.

手術 前後의 Immunoglobulin의 變化

金圭太,金松明,李光淑,李聖行 慶北大學校 醫科大學 1977 慶北醫大雜誌 Vol.18 No.2

手術 前後의 Immunoglobulin의 變化

金圭太,金松明,李光淑,李聖行 慶北大學校 醫科大學 1977 慶北醫大誌 Vol.18 No.2

경북의대 부속병원 흉부외과에서, 흉부대수술을 받은 환자 9명에게 immunoelectrophoresis를 이용하여, 술전 및 술후의 혈청 immunoglobulin値의 변화를 관찰한 바 다음과 같은 결과를 얻었다. Serum total protein, electrophoretic fractions and immunoglobulins levels in serum were measured immediately before and 12 days after major operation in 9 patients, including four tumor patients. Immunoglobulins were determined by radial immuno-diffusion, while serum protein electrophoresis was carried out on cellulose acetate strips. Postoperatively the serum albumin level and the hemoglobin were reduced, but serum total protein did not change. An increase in serum immunoglobulins (IgG, IgA and IgM) was found in most patient 12 days after operation. There was no significant correlation between immunoglobulin level in serum and duration of anesthesia. The patients with the cancer showed significant decrease in serum total protein after operation but no significant difference in serum immunoglobulin levels was found. The patients with the postoperative complication tended to have low serum total protein levels before and folowing operation, but a decrease in immunoglobulin levels was found only before operation.

Subrenal Capsule Assay를 이용한 흰쥐와 Zucker 비만쥐에 폐암세포주 이식의 효과

이동석,김송명,김종인,변정훈 고신대학교 의학부 2005 高神大學校 醫學部 論文集 Vol.20 No.1

The effects of lung cancer cell line in Spague Dowley rats and Zucker's obese rats using subrenal capsule assay. Background/Purpose: Lung cancer is well known as one of the high malignant cancer. So far many clinical trials of multimodality treatment consisted of chemotherapy, radiotherapy and surgery were performed, but the results showed quite difference according to the authors and the 5-year survival rate is still dismal. Presently the subrenal capsule assay is regarded as the best method to assess anticancer chemosensitivity and it's importance is increasing gradually. Recently, obesity due to overnutrition and underexercise has been increased. In this study, we evaluated of the tumor growth and the differences of cancer chemosensitivity after human lung cancer cell implantation between Spargue Dowley rats and Zucker obese rats. Material and Method: Human lung cancer cells(SW-900 G Ⅳ) were cultured on the RPMI 1640 media which contains fetal cow serum and fibrin clot which contains 107 cancer cells(2×2×2mm3). Those cultured cells were implanted to a S.D rats were implanted to a S.D rats and a Zucker obese rats. Group Ⅰ and group Ⅱ were S.D rats and group Ⅲ and group Ⅳ were Zucker obese rats. From the first day to sixth day of implantation, cyclosporin-A(80mg/㎏) was given subcutaneously for immunosuppression. GroupⅠand Ⅲ were given for normal saline, groupⅢ and group Ⅳ were given for NIC (Navelbine 10㎎/㎏, Ifosfamide 30㎎/㎏, measured before and after the implantation. Implanted tumor size and it's histological findings were evaluated and the results of each group were compared. Result: Because of the NIC chemotherapy, group Ⅱ showed loss of the body weight, but group Ⅳ was not affected by the chemotherapy relative and the body weight increased slowly by rat's age. The blood glucose level of each groups were within normal range. But its level of group Ⅱ was less than group Ⅰ by 23㎎%, but group Ⅲ and Ⅳ have similar glucose level which means those two groups were not affected much by the cancer chemotherapy. The growth of implated cancer cells in Zucker obese rats was slow than in S.D. rats. The cancer cell growth of S.D rats was not inhibited by chemotherapy, but chemotherapy influenced to the cancer cell low in group Ⅲ and Ⅳ. Apoptosis were found in group Ⅱ, Ⅳ. All of groups revealed mild inflammation and fibroblasts were observed in group Ⅰ, Ⅲ. Conclustion: This study demonstrates that subrenal capsule assay can be used to determine the response of human lung cancer cell to various combinations of chemotherapeutic agents. And the subrenal capsule assay can be done for the chemosensitivity test for lung cancer cells in short time. In the Zucker obese rats, we certified that meatbolic state related to obesity influenced to human lung cancer cell growth.

흉선종을 합병한 근무력증 치험례

조성래,김송명,허만하 高神大學 醫學部 1985 高神大學醫學部 論文集 Vol.1 No.1