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      • Zoledronic acid가 골육종 세포에서 Matrix Metalloproteinase-2와 -14의 발현과 폐전이에 미치는 영향

        김용백,김상범,권영호,김재도 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

        Purpose : Gelatinase A (MMP-2) and membrane-type metalloproteinase (MT1-MMP, MMP-14) play a critical role in metastasis. It was known that bisphosphonate acts not only to protect bone absorption but also to inhibit tumor invasion and metastasis. The aim of this study is to investigate the inhibition of MMP-2 and 14 in osteosarcoma by zoledronic acid, whether it can prevent lung metastasis in nude mouse. Material and Method : Protein synthesis and mRNA expression of MMP-2 and MMP-14 cultured human MG-63 osteosarcoma and HOS osteosarcoma cell lines with zoledronic acids were measured. In vivo test, it was observed that the inhibitory effect of zoledronic acid on lung metastasis of osteosarcoma with nude mouse model. Result : Zoledronic acid inhibited mRNA expression of MMP-14 and MMP-2 in cultured human MG-63 osteosarcoma and HOS osteosarcoma cell lines. Zoledronic acid decreased the intensity of activated 62KD MMP-2 in human MG-63 osteosarcoma and HOS osteosarcoma cell lines on gelatine zymography. Number of metastatic lung nodule decreased from 9.4 to 1.2 in MG-63 osteosarcoma cell line and from 8 to 1.6 in HOS osteosarcoma cell line with nude mouse model. Conclusion : In vitro, zoledronic acid had an inhibitory effect on the MMP-14 and MMp-2, which also prevents lung metastasis of osteosarcoma in vivo. So, zoledronic acid could be used as one of good chemotherapeutic agents against metastasis of osteosarcoma.

      • 후방인공수정체 공막봉합고정후 발생한 망막박리

        김용백,정상엽 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

        To determine clinical features and outcomes of retinal detachment(RD) after trans-scleral fixation of posterior chamber intraocular lens(PC-IOL), we reviewed 259 eyes (203 patients) that received trans-scleral fixation of PC-IOL between 1988 and 1993 with a minimum follow-up of 6 months retrospectively. The mean age of the patients was 53.4±17 years and the mean follow-up period was 16.2±17 months. The causes of trans-scleral fixation of PC-IOL were as follows: aphakia in 106 eyes, posterior capsule rupture during extracapsular cataract extraction(ECCE) in 78 eyes, intracapsular extraction(ICCE) in 26 eyes, PC-IOL exchange for PC-IOL exchange with PC-IOL in 3 eyes. Retinal detachment occurred in 8 out of 259 eyes(3.2%). The incidences of RDs were as follows: PC-IOL exchange for IC-IOL tilt in 2/9 eyes(10.5%), posterior capsule rupture during ECCE in 1/16 eyes(6.3%), ICCE in 1/26 eyes(3.9%), posterior capsule rupture during phacoemusification in 2/78 eyes(2.6%), aphakia in 2/106 eyes(1.9%), anterior IOL exchange with PC-IOL in 0/3 eyes(0%). The sites of retinal breaks corresponded with the directions of needles during fixation in 5/8 eyes(62.5%) and all retinal breaks were found anterior to the equator. The occurrence of RD was between 2 weeks and 4.8 years after fixation but it occured within 2 months in most cases. Pars plana vitrectomy and scleral buckling was performed in 7 eyes and in one eye scleral buckling was done. Retinal reattachment was achieved in all eight eyes though three eyes required two or more surgical interventions and silicone oil remained in situ in two. The vitretomy should be performed with meticulous care to reduce vitreous traction as much as possible during trans-sclera fixation of PC-IOL and a close follow-up examination for RD is required within at least two months.

      • 유리체절제술중 발생한 의인성망막열공

        김용백,박근성,홍성태 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

        To determine the current incidence, location and treatment of intraoperative iatrogenic retinal breaks occuring during pars plana vitrectomy, we reviewed the records of 208 consecutive eyes after pars plana vitrectomy. Thirty seven of 208 eyes (18%) developed 68 intraoperative tears. Of the 68 tears, 14 (21%) were located in the anterior to equator and 54 (79%) were located in the posterior to equator. Thirty six retinal tears (43%) were located in the upper quadrants and in the lower quadrants, we detected 47 retinal tears (57%). Patients with proliferative diabetic retinopathy and proliferative vitreoretinopathy had a higher incidence of iatrogenic retinal breaks than those with other diagnoses. Methods used to treat the retinal tears included cryotherapy, laser photocoagulation, scleral buckling, internal tamponade of gas, air and silicone oil. Thirty three of 37 eyes (89%) were reattached. According to the use of endolaser photocoagulation, we divided the period of study that the first half : 1989. 5. - 1991. 6. and the second half : 1993. 1 - 1993. 12. The results of chorioretinal adhesion in the 1st half were higher than those of the second half. These results show that vitreoretinal surgery for proliferative diabetic retinopathy and proliferative vitreoretinopathy requires careful managements for prevention of iatrogenic retinal tears. Despite improvements in instrumentation and surgical techniques, iatrogenic retinal tears continue to be an important complication of pars plana vitrectomy. However, with careful intraoperative examination, most iatrogenic retinal tears can be identified and treated successfully.

      • Zoledronic acid가 골육종 세포에서 Matrix Metalloproteinase-2와 44의 발현과 폐전이에 미치는 영향

        김용백,김상범,권영호,김재도 고신대학교(의대) 고신대학교 의과대학 학술지 2006 고신대학교 의과대학 학술지 Vol.21 No.1

        Purpose : Gelatinase A (MMP-2) and membrane-type metalloproteinase (MT1-MMP, MMP-14) play a critical role in metastasis. It was known that bisphosphonate acts not only to protect bone absorption but also to inhibit tumor invasion and metastasis. The aim of this study is to investigate the inhibition of MMP-2 and 14 in osteosarcoma by zoledronic acid, whether it can prevent lung metastasis in nude mouse. Material and Method : Protein synthesis and mRNA expression of MMP-2 and MMP-14 cultured human MG-63 osteosarcoma and HOS osteosarcoma cell lines with zoledronic acids were measured, In vivo test, it was observed that the inhibitory effect of zoledronic acid on lung metastasis of osteosarcoma with nude mouse model Result : Zoledronic acid inhibited mRNA expression of MMP-14 and MMP-2 in cultured human MG-63 osteosarcoma and HOS osteosarcoma cell lines. Zoledronic acid decreased the intensity of activated 62KD MMP-2 in human MG-63 osteosarcoma and HOS osteosarcoma cell lines on gelatine zymography. Number of metastatic lung nodule decreased from 9.4 to 1.2 in MG-63 osteosarcoma cell line and from 8 to 1.6 in HOS osteosarcoma cell line with nude mouse model. Conclusion : In vitro, zoledronic acid had an inhibitory effect on the MMP-14 and MMP-2, which also prevents lung metastasis of osteosarcoma in vivo. So, zoledronic acid could be used as one of good chemotherapeutic agents against metastasis of osteosarcoma.

      • 안내이물과 안내염

        김용백 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

        Thirty-one consecutive cases of ocular injuries with retained intraocular foreign body(IOFB) are examined in this retrospective study. The incidence was more common in the young adult male and most of IOFBs occured while hammering at work. The nature of IOFB was mostly magnetic. The prevalent location for IOFB was at the posterior segment. Bacterial cultures of removed intraocular material were positive in 11 cases but none of the 31 cases presented with or developed clinical signs of postoperative endophthalmitis. The better positive culture was obtained in case of larger size of IOFB, longer retention time of IOFB in eyeball. Prompt surgical intervention, the use of intravitreal antibiotics in high-risk-type injuries, and the possible uses of vitrectomy surgery may reduce the incidence and severity of endophthalmitis.

      • 감염성 안내염의 진단 및 치료

        김용백 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

        To determine(1) which technique of microbiologic diagnosis is most effective, (2) whitch antibiotics are drugs of choice for initial intravitreal antibiotics, and (3) which factors influence visual outcome of endophthalmitis, the medical records of 32 patients(32 eyes) with infectious endophthalmitis who were treated at our institution between September 1989 and September 1993 were reviewed. Pars plana vitrectomy was performed in 30 eyes, along with intraocular antibiotics injection. A sample of vitreous diluted by the irrigating solution was passed through a disposable membrane filter system and inoculated into the blood-culture bottle. In 31(97%) of 32 eyes, microorganisms were identified. The most frequent pathogen was Staphylococcus epidermidis(28.9%). Vancomycin and Amikacin were considered the drugs of choice for initial intravitreal antibiotics. There was no difference in visual outcome between etiologic categories. Eyes with endophthalmitis developed between 4 days and 4 months after inoculating event have better visual prognosis than those with earlier onset (p = 0.022). Overall, 17(53%) of 32 patients achieved a visual acuity of 20/400 or better. Postoperative complications included retinal detachment(5 eyes), glaucoma, recurrence of endophthalmitis and macular degeneration. For effective management of infectious endophthalmitis, we recommend the use of membrane filter system and blood-culture bottle and prompt initiation of broad-spectrum intravitreal antibiotics(Vancomycin and Amikacin), along with vitrectomy if necessary.

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