미세혈관의 결찰방법에 따른 혈관의 조직학적 연구

김현수,김정태,김석권 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.2

급성신부전, 막성 신병증과 간염이 합병된 제2기 매독1례

김현수,박영정,엄흥식,이활연,최상봉,김상현,박원도 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Syphilis is a systemic infectious disease infected by the spirochete Treponema pallidum. It shows variable clinical manifestations. Nephrotic syndrome from secondary syphilis is a rare complication in Korea. One letter was reported before in Korea. This report describes 64-year-old male patient with syphilis presented with feature of hepatitis, acute renal failure and nephrotic syndrome. A diagnosis of secondary syphilis was done by the serologic test for syphilis. After diagnosis of syphilis, we supposed that nephrotic syndrome and hepatitis were the complication of secondary syphilis and performed a kidney biopsy. A kidney biopsy revealed membranous nephropathy characterized by subepithelial deposits involving the glomerular basement membrane and effacement of epithelial foot-process on electron microscopy. The patient was treated with intramuscular benzathine penicillin 2.4 million units. Proteinuria, renal failure, hepatitis were resolved in 3 weeks after penicillin therapy.

녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.

다혈관 질환을 가진 급성 관동맥 증후군 환자의 약물 용출 스텐트를 이용한 심혈관 중재 시술 : 단일혈관 시술과 다혈관 시술의 비교

김현수 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Background : We evaluate the efficacy and safety of ‘culprit vessel only' versus complete revascularization using drug-eluting stents (DES) for treatment of acute coronary syndrome (ACS) with multivessel coronary artery disease. Methods : We retrospectively analyzed 187 patients (mean age 60±11 years) of acute coronary syndrome with multivessel disease suitable for stent deployment. Patients who were divided into two groups; group 1 (n=108) underwent percutaneous coronary intervention (PCI) for culprit vessel only with DES, and group 2 (n=79) underwent complete revascularization at least two DES. The culprit vessel was defined by reviewing pateint's coronary angiogram, electrocardiogram, echocardiogram and/or nuclear stress test. Major adverse cardiovascular (MACE ; myocardial infarction, CVA, or death) and the incidence of revascularization of culprit and non-culprit vessel(s) were evaluated. Results : 108 patients (57.4%) at culprit vessel only group and 79 patients (42%) were complete revascularzation group. Mean follow-up duration was 26±21 month. There was no significant difference of baseline clinical and angiographic characteristics between two groups, and there was no significant difference in MACE; 13(11.5%) in culprit only group 1 and 6(8.2%) in complete revascularzation group 2(p = 0.695). In the rate of non-culprit vessel(s) revascularization, group 1 showed higher than group 2(n=45 [60.4%] vs. 14 [29.7%], respectively, p<0.001), while there was no significant difference in the rate of culprit vessel revascularization(group 1; n=16 [21.3%], group 2: n=20 [33.9%]. p=0.119). Conclusion : Based on this study, in clinical practice, we should positively consider DES-based complete revascularization rather than 'culprit vessel only' revascularization for the treatment of acute coronary syndrome with multivessel disease suitable for stent deployment.

계면활성제를 이용한 유류침적토양의 세정효과

김현수,조대철 순천향대학교 부설 산업기술연구소 2001 순천향 산업기술연구소논문집 Vol.7 No.2

This paper is on an efficient chemical soil flushing method that cleans over-loaded oil contaminated sand-soil. We used batch and continuous modes of flushing using ionic and non-ionic surfactants, sonsidering particle(soil) size, surface electricity, and soil matrix. Surfactant concentration, soil porosity, and flow rate of flushing solutions are regarded as critical variables for oil solubilization and elution of oil from soil matrix. From the batch experiments, Tween-80 solutions showed much greater washing effect than SDS solutions on molecular basis. The maximum washing efficiency was more than 74% at 2 wt% of SDS. The greater removal rate was; the greater the surfactant concentration, the smaller the porosity, the greater the flow rate. Batchwise operation resulted in higher removal rete than continuous mode regardless of retention times. That is possibly because the rate determining step in solubilization is better controlled by the batch mode.

복부 대동맥류를 동반한 환자에게서 발견된 좌주간지에서 기인하는 우측 관상 동맥 1 예

김현수 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

비정상적으로 기인하는 관상 동맥은 드물게 볼 수 있으나, 심근 허혈이나 드물게 돌연사 까지 유발할 수 있는 심각한 질병이다. 본 증례와 같이 우측관상동맥이 좌주 간지와 같이 기인하여 대동맥과 폐동맥 사이로 주행하는 경우, 관상 동맥의 폐색이나 협착 없이 협심증과 유사한 흉통을 유발할 수 있고, 드물게 돌연사를 유발할 수 있어 특히 주의를 요한다. Anomalous origin of the right coronary artery(RCA) with interarterial course is a rare but lift-threatening anomaly causing sudden death in young adult. A 70-year-old male was admitted with chest pain and epigastric discomfort. At initial evaluations, he took anti-ulcer medicine in the impression of gastric ulcer and gastroesophageal reflux disease from the other department. With regardless of treatment, he felt chest discomfort intermittently. At abdominal CT scan, infrarenal abdominal aortic aneurysm (3.4x3.3 Cm) was found, but he was transferred cardiologic department for the conservative treatment because the size is not indicated for operation. We performed coronary angiogram to rule out ischemia due to continuous chest pain and found that RCA arises from the os of left main coronary artery and runs forward between ascending aorta and pulmonary arterial trunk. His chest pain was improved with beta blockers and angiotensin receptor blockers.

실리콘 쿠션이 부착된 골절판계의 응력 해석

金賢洙,崔泰元 동아대학교 공과대학 부설 한국자원개발연구소 1994 硏究報告 Vol.18 No.2

Conventional compression bone fracture plates sometimes cause osteoporosis due to their high rigidity. Many researchers have attempted various types of bone plates in order to prevent the osteoporosis. To meet the same purpose, a new concept bone plate with silicon rubber cushion between bone plate and bone is introduced. Earlier preliminary animal experiments in vivo and mechanical tests in vitro results show that the new concept bone plate can help prevent the osteoporosis. The purpose of this study is to investigate the effect of silicon rubber cushion on the stress shielding using 3-dimensional finite element method. The simulations were performed for compression, closed bending, and open bending respectively. The results supports the trends of the earlier preliminary in vivo results.

數種 微生物 抽出物이 人 인터페론 誘發에 미치는 영향

金炫洙 건국대학교 1985 論文集 Vol.20 No.1

The effects of some microorganism extracts on the yield of interferon, when added to the interferon-inducing medium, was investigated using Sendai virus (30HAu/106 cells) as inducing virus in Namalva cells, the human lymphoblastoid cells. The extracts of phototrophic bacteria (Rhodopseudomonas capsulatus, Rhodopseudomonas sphaeroides, Rhodopseudomonas palustris, Rhodopseudomonas viridis, Rhodospirillum rubrum) increased the yield of interferon, while that of Bacillus subtilis (ATCC-6633) decreased it. The extracts of Monascus sp., Aspergillas niger sp. and Pseudomonas pyoceanea (NCTC-10490) each showed no significant effect at the concentration of 0.5% (V/V) compared with the control group with no extract added. Among the phototrophic bacteria tested, the extracts of nonsulfur bacteria were more effective in the induction of interferon than that of sulfur bacteria. To know the optimal concentration condition of the phototrophic bacteria extract for the highest yield of interferon, the concentration of the added extract was varied. The optimal concentration condition was found to be 0.03∼0.05% (V/V).

기립경사 검사 중 경흉부 심초음파로 측정한 정상 좌심실의 혈역동학적 변화

김현수 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Background : Vasovagal syncope, i.e, neurally mediated syncope is common disorder in clinical practice. Previously, neurally mediated syncope has been known to result from mechanoreceptor discharge by vigorous ventricular contraction. However, the precise mechanism is not known exactly until now. So. we try to evaluate hemodynamic change during tilt table test with echocardiographic parameters in syncope patients. Methods : We evaluated 35 patients with episode of unexplained syncope. Tilt table test including passive tilting and tilting with isoproterenol was done at all patients. During the test, echocardiographic parameters (left atrial dimension and volume, left ventricular dimension, ejection fraction and mitral inflow pattern) were recorded at each stage : at baseline, passive tiling 0, 20 minutes, tilting with isoproterenol 5, 15 minutes. Results : The 35 patients (mean 41±17 years, 24 male) undergone tilt table test all stage without syncope(negative group). During the test, significant, progressive reduction of left ventricular end-diastolic, end-systolic dimension, left atrial volume were shown. However, left ventricular ejection fraction showed decline at early phase but, increased at late phase during infusion of isoproterenol. Similar pattern was seen in aortic valve velocity time integral and peak velocity. Mitral inflow pattern showed normal filling pattern at initially, but showed relaxational abnormal pattern at late phase. E/e ratio was increased slightly and substantially during the test. Conclusion : Tilt table test is useful diagnostic tool for evaluation of syncope. Decreased inflow into left heart and compensatory hypercontraction of left ventricle and diastolic dysfunction were seen during tilt table test.

2차원 심초음파와 3차원 심초음파로 측정한 좌심방의 크기

김현수 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Background : Left atrial(LA) size is important prognostic factor at various cardiovascular conditions. Various methods are used in assessment of LA size. Among those, ellipsoidal method is widely used in clinical practice, but it’s accuracy is not confirmed. Thus we prospectively measured LA size with various methods and evaluate superiority Methods : This prospective study include 49 patients (23 male, mean age 60.6 ± 13 years) without history of atrial fibrillation, valvular heart disease, pacemaker implantation, congenital heart disease. All patients underwent echocardiography, and LA volume was measured by linear dimension, ellipsoidal methods, modified Simpson’s methods and 3-dimensional echocardiography. Results : Mean LA volume was 28.03 ± 12 ml/m3 by ellipsoidal method, 34.98 ± 14 ml/m3 by modified Simpson’s method and 30.37 ± 12 ml/m3 by 3 dimensional echocardiographic measurement. The 3D echocardiographic and 2D echocardiographic methods were correlated. Pearson correlation coefficient were 0.84 for 3 dimensional measure versus ellipsoidal method and 0.76 for 3 dimensional measure versus modified Simpson’s method 0.59 for 3D measure versus anterior-posterior(AP) diameter(all p values < 0.001). Ellipsoidal method and modified Simpson’s method showed good correlation, but 3D versus AP diameter showed poor correlation. 2D echocardiographic measurements showed trend of overestimation of LA volume especially enlarged LA size. Ellipsoidal method have trend to underestimate LA volume than modified Simpson’s method compared to 3D echocardiographic measurement, but they didn’t showed any significance(p=0.918). Conclusion : To measurement of LA volume, various methods were used. Both 2D echocardiographic methods (Ellipsoidal methods, modified Simpson’s methods) have good correlation compared to 3D echocardiographic measurement. But there was trend to overestimate at larger LA size with 2D echocardiographic measurement.