다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

董氏鍼을 加味한 治療가 中風患者의 NIHSS와 MBI상의 단기간 기능회복에 미치는 영향

조태성,손인석,김철홍,서정철,윤현민,장경전,송춘호,안창범 동의대학교 한의학연구소 2002 동의ㆍ경산 한의학 학술대회 Vol.6 No.-

Helicobacter pylori와 대장균의 Shuttle Vector 개발

조명제,이우곤,이상룡,김경희,안영숙,김성희,김현주,류복덕,최여정,윤영혜,백승철,전영석,이광호 경상대학교 유전공학연구소 1997 遺傳工學硏究所報 Vol.16 No.-

In this study, a vehicle vector using cryptic plasmids was constructed for gene transfer in Helicobacter pylori. pHP51(3.9 kb) and pHP489(1.2 kb) were selected for constructing vectors from cryptic plasmid of H. pylori isolates in Korea. The HindⅢ-digestedDNA fragment(1.2kb) of pHP489 and 1.6kb DNA fragment of pHP51 were ligated with a kanamycin resistance gene(aph3'-Ⅲ) from C. jejuni to produce the recombinant plasmids pHP489K and pHP51K, respectively. Transformation frequency of pHP51K by electroporation was low. But pHP489K could be effectively transformed into various H. pylori strains. In order to design an intermdiate vehicle vector for gene transfer into H. pylori, pBlueHP489K was prepared by recloning pHP489K DNA into pBluescript and pTZ19R vector. This vector permitted the DNA fragment containing pHP489 sequence, aph3'-Ⅲ, and cloned DNA to be cut and self-ligated in the SacⅠ site after cloning. ureA and ureB gene were inserted into pBlueHP489K, resulting in pBlueHP489K/AB. The DNA fragment containing pHP489, kanamycin resistance gene(aph3'-Ⅲ), and urease structural gene was cut away from pBlueHP489K/AB and self-ligated to generate pBlueHP489K/AB. pBlueHP489K/AB made urease-negative H. pylori strains restore their urease activity. By this experiment, pBlueHP489K was confirmed to be the vehicle system for transferring H. pylori genes.

상부 조기 위암 환자의 복강경하 상부 위절제술 3례 경험

조규석,김형철,박경규,이문수,송옥평,임철완,신웅진,주종우,유기원 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Background : The reported incidence of early gastric cancer located in the upper portion of the stomach has been increasing with the recent advances in its diagnosis and screening. Recently, we have successfully performed laparoscopic assisted proximal gastrectomy and gastric tube reconstruction without pyloroplasty on three patients with early gastric carcinoma localized to the upper third of the stomach. We describe our modification of this procedure in this report. Method : After creating an surgical pneumoperitoneum, the stomach was mobilized using laparoscopic coagulating shears. Upper half of the greater curvature and three-quarters of the lesser curvature were then dissected along with regoinal D2 lymphadenectomy. This was followed by a 5 cm, longitudinal mini-laparotomy in the upper abdomen, and the construction of the exteriorized stomach with a gastric tube measuring 20 cm long and 4 cm wide. Reconstruction with an esophagogastrostomy was performed using a circular stapler. Result : No post-operative morbidity or mortality was observed in this small series of patients. The average operative time was 250 minutes (range 220-300 minutes), and the average blood loss was 150 ml (range 90-180 ml). The mean number of lymph nodes harvested during these laparoscopic proximal gastrectomies was 24 nodes (range 22-25 lymph nodes). The average postoperative hospital stays was 7.5 days (range 7-8 days). Conclusion : Our technique of laparoscopic assisted proximal gastrectomy and gastric tube reconstruction without phloroplasty offers a minimally invasive technique with the potential of impoving the post-operative quality of life patients with an early-stage proximal gastric cancer.

개에서 발생한 이혈종의 임상적 관리

이우철,윤기영,서경원,최호정,정성목,송근호,조종기,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2012 動物醫科學硏究誌 Vol.19 No.1

A 14-year-old male pomeranian was present with swollen left ear. The swelling occurred from base to apex of pinna. Otitis externa persisted for two years. Hematological and serum biochemistry values were not remarkable. The surgery treatment was the most appropriate method among indwelling drain, surgical, and steroid treatment in the aural hematoma because the dog was very sensitive to touching pinna and the size of aural hematoma. Longitudinal incision was applied after general anesthesia. Cefovecin was injected to prevent secondary infection. The outcome of surgery was good. There was no evidence of recurrence for one year.

수종의 엔진구동형 Nickel-Titanium file을 이용한 근관형성 방법이 근관만곡도 유지능력에 미치는 영향

이철환,조경모,홍찬의 大韓齒科保存學會 2003 Restorative Dentistry & Endodontics Vol.28 No.1

There are increasing usage of Nickel-Titanium rotary files in modern clinical endodontic treatment because it is effective and fater than hand filing due to reduced step. This study was conducted to evaluate the effect of canal preparations using 3 different rotary Nickel-Titanium files that has different cross sectional shape and taper on the maintenance of canal curvature. Simulated resin block were instrumented with Profile(Dentsply, USA), GT rotary files(Dentsply, USA), Hero 642(Micro-Mega, France), and Pro-Taper(Dentsply, USA). The image of Pre-instrumentation and Post-instrumentation were acquired using digital camera and overspreaded in the computer. Then the total differences of canal diameter, deviation at the outer portion of curvature, deviation at the inner portion of curvature, movement of center of the canal and the centering ratio at the pre-determined level from the apex were measured. Results were statistically analyzed by means of ANOVA, followed by Scheffe test at a significance level of 0.05. The results were as follows; 1. Deviation at the outer portion of curvature, deviation at the inner portion of curvature were showed largest in Pro-Taper, so also did in the total differences of canal diameter(p<0.05). 2. All the groups showed movements of center. Profile combined with GT rotary files and Hero 642 has no difference but Pro-Taper showed the most deviation(p<0.05). 3. At the 1, 2, 3mm level from the apex movements of center directed toward the outer portion of curvature, but in 4, 5 mm level directed toward the inner portion of curvature(p<0.05). As a results of this study, it could be concluded that combined use of other Nickel-Titanium rotary files is strongly recommended when use Pro-Taper file because it could be remove too much canal structure and also made more deviation of canal curvature than others.

연취급 근로자들의 면역능의 변동에 관한 조사

류철인,조병만,이지호,황인경,이수일,김돈균 大韓産業醫學會 1991 대한직업환경의학회지 Vol.3 No.2

Lead induced immunological responses were examined in 16 workers who were occupationally exposed to lead, and 8 healthy meadical students who did not have previous history of lead exposure. The proportion of OKT3+ cell, OKT4+ cell, OKT8+ cell, B cell to the total lymphocytes in peripheral blood and the ratio of OKT4+ cell to OKT8+ cell(OKT4/OKT8) were used to assess the immunological effects. The results were summarized as follows ; 1. In the lead workers, blood lead (21.7 ±7.6㎍/100㎖), zinc protoporphyrin (53.1 ±29.9㎍/100㎖) and urinary lead (54.8 ±17.7㎍/ℓ) were significantly higher than those of the nonexposed subjects (p<0.01). 2. The proportion of OKT3+ cell, OKT4+ cell and OKT4+/OKT8+ were lower in lead workers compared to nonexposed subjects. But this difference was not statistically significant (p>0.1). 3. The proportion of B cell was slightly higher in lead workers compared to nonexposed subjects (P=0.15). 4. The proportion of OKT8+ cell of lead workers was comparable to that of nonexposed subjects.

톨루엔 디이소시아네이트 폭로 근로자들의 작업방법에 따른 대사물질의 비교 및 면역능에 관한 연구

이수일,조병만,황인경,이철호,박정래 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.3

Following recent advanced industrialization, the amount of polyurethane to use as thermal insulating materials, upholstery, mattresses and packing materials in automotive and furniture industry is increasing world-widely, and the number of polyurethane-producing worker will be increased. Because the numerous organic solvents are used in polyurethane-producing factory, the workers in this work site is exposed to many organic solvents. Of the organic solvents, Toluene Diisocyanate(TDI) has many hazardous effects to human. The effects of TDI on human are the irritation to respiratory mucosa and gastrointestinal symptoms. Conjunctival irritation, dermal inflammation (redness, pain, vesicular formation) and gastrointestinal symptom(nausea, vomiting. abdominal pain) are reported just after short-term exposure of TDI. TDI is known to give rise to bronchial asthma, as the immune disorder. And because of strongly volatile characteristics of TDI, it is suggested as a more injurious material to human health, especially human immune system, than other organic solvents. Bronchial asthma inducing mechanism of TDI is not clearly known, but on the analogy of TDI induced symptoms and recent studies, early-onset asthma is type I hypersensitivity reaction mediated by immunoglobulin E(IgE), and late-onset asthma is maybe type III hypersensitivity reaction by circulating IgG. And we know that the complicated human immune function is likely to move in such that mechanisms, there are not studies on immune indices evaluating the bronchial asthma-related immune function. The evaluation of change patterns of humoral immunity including IgE and IgG and cellular immunity including T-helper cell. T-suppressor cell and T-cytotoxic cell will be helpful to evaluate exposure degrees and prognosis in TDI exposed workers. Because TDA(toluene diamine) as a biological exposure index of TDI becomes the focus of interest, we know that a study on the correlation between urinary TDA and air TDI and immunological indices will make a contribution to biological effect monitoring indicies. We examined human immunity indicators such as WBC, %Lymph (percentile of Lymphocyte in WBC), %T-cell(percentile of T-lymphocyte in total lymphocyte). CD4, CD8, C3, C4, IgA, IgG, IgM, IgE in peripheral blood to evaluate the health hazard of the TDI-exposed workers. And we examined TDA to evaluate correlation between exposure and effect. Total 90 subjects was selected, 45 workers who worked in the polyurethane-producing factories as an exposed group, and 45 cases who were office workers(10 cases), other blue collors(27 cases), and medical college students(8 cases) as a control group. And the results were as follows; 1. The logarithm of IgE-Log10(IgE)±SD-in peripheral blood of a exposed group was significantly higher than a control group, 2.22 ±0.62 in case group compared with 1.98±0.53 in control group. (p<0.05) 2. IgA and IgM in the polyurethane-producing workers were 261.02±83.12㎎/㎗, 151.97 ±59.64 ㎎/㎗, respectively, and 292.77±100.45, 179.17±100.78 in control group. IgA and IgM was slightly lower in polyurethane-producing group than control.(p>0.05) 3. WBC, %Lymph. %T-cell, C3, C4, CD4, CD8, CD4/CD8 ratio and IgG in case group were 6.391.1 ea/㎖, 37.53 %, 59.54 %, 76.68 ㎎/㎗, 0.76×10(9) ea/L, 0.63×10(9) ea/L, 1.39, and 1606.29 ㎎/㎗, respectively, and 6,974.7 ea/㎖, 35.12 %, 59.64 %, 71.95 ㎎/㎗, 33.94 ㎎/㎗, 0.80×10(9) ea/L, 0.61×10(9) ea/L, 1.39, and 1581.51 ㎎/㎗ in control group. There was no statistical significance between two groups.(p>0.05) 4. In the comparison of each other companies, average of individual urinary TDA in polyurethane paint manufacturing companies is higher than that of polyurethane sponge foaming companies. And, the concentration of 2.6-TDA which is a metabolite of well-vaporized 2.6-TDI is higher than that of 2.4-TDA in the polyurethane sponge foaming companies. But, the concentration of 2.4-TDA which is a metabolite of illvaporized but well skin-absorbed 2.4-TDI is higher in polyurethane paint manufactures. 5. There were no statistical significance in the correlations between individual urinary TDA and immunologic indices.

유방암과 섬유선종의 방사선학적 소견 : 유방 단순촬영술과 유방 초음파검사 소견의 비교 연구 Studies on mammographic and ultrasonographic findings evaluation

임한혁,최득린,고은석,이혜경,임철완,이상진,홍현숙,최교창,김영화,박재성 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

Purpose : To evaluate the utility of mammography and ultrasonography in study of morphologic differential diagnosis between malignant and benign mass. Materials and Methods : Average age of patients with breast cancer was 48.4 year-old, and that of fibroadenoma was 29.4 year-old. The equipments used for examination were MF-159 high frequency mammography(Bennet Co.) and Acoustic image 5200S. We evaluated mammographic findings about breast parenchymal pattern, calcification, margin and size of the mass associated tumor nature, and ultrasonographic findings about shape, height and width, internal homogenicity and echo pattern, wall contour, boundary echo, and posterior shadow in breast mass. Thirty-seven of mammographic findings and 34 cases of ultrasonogreaphic findings in pathologically proven breast cancer and 34 case of mammographic findings and 71 cases of ultrasonographic findings in breast fibroadenoma were reviewed retrospectively. Results : In mammographic study, the parenchymal patterns of breast cancer according to Wolfe classification were NI(16.2%), PI(24.3%), P@(37.8%), and DY(21.6%) and those in fibroadenoma were NI(3.1%), Pl(11.7%), P2(35.2%),and DY(50%). Mammographic findings about presence of calcification were as follows; only calcification(16.2%), only mass(51.3%), and mass with calcification(32.5%) in breast cancer, and only mass(91.2%), mass with calcification(8.8%) in fibroadenoma. The features of mass margins were classified as ill-defined margin(45.9%), well-defined(5.4%), and well-defined with partial spiculation(48.6%) in breast cancer and ill-defined(20.5%), well-defined(73.5%), and well-defined with partial spiculation(5.8%) in fibroadenoma. The mass were grouped by size; 1-2cm(37.8%), 2-4cm(45.9%), and 4-6cm(16.3%) in breast cancer and 1-2cm(79.4%), 2-4cm(17.6%), and 4-6cm (3.0%) in fibroadenoma. On ultrasonographic study, the shape of masses in breast cancer were lobulated(82.3%),oval(14.7%), and round(3.0%),and those in fibroadenoma were lobulated(14.0%), oval(57.7%), and round(18.3%). The cases that the height was longer than width were 32.3% in breast cancer and 0% in fibroadenoma. The findings about homogenecity and echo patterns were as follows; hypoechoic(52.9%) and mixed(47.1%) in breast cancer and hypoechoic(2.8%), hypoechoic(63.4%), and mixed(33.8%) in fibroadenoma. The margin of masses were smooth in 85.9% of fibroadenoma, and irregular in 73.6% of breast cancer. The boundary echoes of masses and decreased posterior echo shadow were seen only in 61.8% and 55.9% of breast cancer, respectively. Conclusion: The margin and calcifications are more clearly delineated on mammography but breast cancer and fibroadenoma, both are more commonly developed in dense parenchymal pattern(P2+DY),and there findings are easily obscured in mammography. So ultrasoography is very useful in these masses evaluation, especially amoung young patients.

경정배양에 의한 카네이션(Dianthus caryophyllus L.)의 기내증식과 순화

양회형,조경철,김광수,황인택 全南大學校 農業科學技術硏究所 1999 農業科學技術硏究 Vol.34 No.-

본 실험은 카네이션의 경정배양을 통한 기내증식체계를 확립하고 기내증식과정 중 발생하는 투명묘의 발생을 억제하기 위하여 실시하였으며, 발근과 순화과정을 통합함으로써 그에 따르는 경비와 노동력을 절감할 수 있는 방안을 마련하는 한편, 기내에서 얻은 묘를 직접 재배에 이용할 수 있는 방법을 개발하기 위하여 실시하였다. 경정배양에서 생존율은 Benzyladenine (BA) 또는 Kinetin (KI) 0.1㎎/ℓ 첨가한 모든 배지에서 80%이상이었으나 그 이상의 농도에서는 농도가 증가할수록 생존율이 감소하였으며, Naphthaleneacetic acid (NAA) 또는 Indoleacetic acid (LAA) 0.1㎎/ℓ 혼합첨가시에는 2.0㎎/ℓ까지는 농도에 관계없이 모든 처리구에서 생존율이 75%이상이었다. 경정배양에서 얻은 신초의 증식배양에서 LAA나 NAA의 첨가에 관계없이 KI보다 BA를 첨가하면 신초발육이 더 좋았다. MS배지의 무기염류를 4배로 첨가한 4MS배지에서는 신초가 모두 고사하였고, 1 MS배지에서 신초의 발육이 가장 좋았다. Sucrose 무첨가 배지에서 신초의 발육이 가장 좋았다. Sucrose 무첨가 배지에서 신초의 발육은 거의 이루어지지 않았고, sucrose 20㎎/ℓ첨가배지에서 신초의 발육이 가장 좋았다. 한천보다 겔라이트 첨가배지에서 신초의 발육이 좋았다. 배지 pH는 5.0에서 신초의 발육이 가장 양호하였다. 투명화묘의 발생은 경정배양과 계대배양 전과정에서 발생하였고, 한천 또는 겔라이트의 농도를 높여주었을때에 억제되었다. 발근 및 순화단계에서 신초의 발육과 근형성은 sand, vermiculite배지에서 보다 perlite배지에서 더 좋았다. This study was carried out to establish a system for clonal multiplication and preventing vitrification in shoot tip culture of carnation. Combining the two steps of rooting and acclimatization, it may possibly reduce the cost and save the labor for clonal propagation. In addition, the plantlets raised by this one step rooting and acclimatization could be directly transferred to soil. The survival rate was over 80% in the media containing 0.1㎎/ℓ benzyl-adenin (BA) or kinetin (KI), but decreased as the concentration increased. When auxins were added in combination with cytokinins, the survival rate was over 75% regardless of the cytokinin concentration up to 2.0㎎/ℓ. When the in vitro shoots were subcultured, shoot development was better in the media containing BA than those containing KI regardless of addition of indoleacetic acid (LAA) of α-naphthalene acetic acid (NAA). Shoot development was the best in the standard MS medium(1xMS), while all the shoots on the medium containing 4 times the inorganic salts of MS medium(4xMS) died. Shoot development in MS medium free of sugar was not noticed. The MS medium containing 20g/ℓsucrose resulted in the best shoot growth. Shoot development was better on the media containing gelrite than those containing agar. The MS medium at pH 5.0 favored the shoot development. Vitrification of shoots occurred during the initial shoot culture as well as during the subculture of the in vitro shoots, but it was suppressed when the concentration of gelrite or agar in the media was increased. As the substrate for rooting and acclimatization of the in vitro shoots, perlite was better than sand or vermiculite.