췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

상아질 접착에서 collagenase와 esterase가 미세인장결합강도에 미치는 영향

정영정,현홍근,김영재,김정욱,이상훈,김종철,한세현,장기택 대한소아치과학회 2007 대한소아치과학회지 Vol.34 No.2

상아질-레진 접착강도에 대한 collagenase와 esterase의 영향을 살펴보기 위해, 소구치의 교합면 상아질에 Single Bond 2와 Clearfil SE Bond로 접착을 시행하고 미세 시편을 제작하여 PBS, collagenase 용액, esterase 용액에 4주간 보관한 후 미세인장결합강도를 측정, 비교하여 다음과 같은 결론을 얻었다. 1. 모든 보관 용액에서 Single Bond 2의 미세인장결합강도는 Clearfil SE Bond보다 유의하게 낮았다(p<0.05). 2. Single Bond 2의 미세인장결합강도는 collagenase군이 PBS군, esterase군보다 낮았다(p>0.05). 3. Clearfil SE Bond의 미세인장결합강도는 esterase군이 PBS군에 비해 낮았으나(p>0.05), collagenase군보다는 높았다(p>0.05). Collagenase군은 PBS군에 비해 유의하게 낮은 미세인장결합강도를 보였다(p<0.05). The purpose of this study was to evaluate the effect of collagenase and esterase on the microtensile bond strength (μTBS) in dentin bonding. After resin composites were bonded to occlusal dentin, μTBS specimens were formed and stored in PBS, collagenase, or esterase solution. After 4-week storage, μTBS was determined and, the results were as follows: 1. μTBS values of Single Bond 2 were lower than those of Clearfil SE Bond for all storage medium (p<0.05). 2. In single Bond 2 group, collagenase solution lowered bond strength more than PBS and esterase solution (p>0.05). 3. In Clearfil SE Bond group, esterase solution lowered bond strength more than PBS(p>0.05). Collagenase solution lowered bond strength more than esterase solution(p>0.05) and PBS(p<0.05).

기종성 신우신염 1례

이재욱,구정태,서정일,양창헌,이정호,이동철,이영현,이활,이경섭 동국대학교 경주대학 1997 東國論集 Vol.16 No.1

기종성 신우신염은 주로 당뇨병환자나 폐쇄성 요로질환을 가진 환자에 발생하며 특징적으로 신실질 및 그 주위조직에 가스를 형성하면서 심한 조직괴사를 일으키는 매우 드문 급성 화농성 신감염으로 사망률이 높은 질환이다. 이 질환은 1989년 Kelly와 MacCallum에 의해 처음 보고된 이래 외국문헌에 약 90례 정도가 보고되어 있으며 국내에는 28례가 보고되어 있다. 수액 및 전해질 보충, 인슐린 투여를 통한 적절한 혈당조절 및 항생제 투여등의 내과적 치료와 절개배농 및 신적출술등의 수술적 치료 방법이 있다. 내과적 치료로 가스의 감소가 없는 경우에는 즉각적인 수술적 치료를 시행하여야하므로 이 가스변화에 대한 추적관찰이 중요하다 하겠다. 본 저자들은 당뇨병환자에서 발생한 기종성 신우신염 1례를 내과적 요법을 치험하였기에 문헌고찰과 함께 보고하고자 한다. Emphysematous pyelonephritis is rare, life-threatening infection of the renal parenchyma and perirenal tisseue. This disease is characterized by the production of intrarenal and perirenal gas and is frequently encountered in patients with diabetes mellitus or urinary obstruction. We experienced a case of emphysematouse pyelonephritis in a 62 years old women with poorly controlled diabetes mellitus who had been managed with medical theraphy. So we report this case with a review of the referenced literatures.

편두통 환자의 임상 양상 및 생체전기 자율반응과의 상관성 고찰

이현종,정인태,김수영,이두익,김건식,이재동,이윤호,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Objective : We had a clinical report in headache but didn't in migraine. We have planned this study in order to get the basic data of migraine in oriental medicine. Methods : The patient of 36 in migraine checked sec, age, onset, family history, severity of pain, influences of life, induced cause, clinical pain characteristics, associated symptom, treatment style, and paescription, frequency, using period of analgesics by a questionnaire and differentiated syndromes in migraine and evaluated autonomic bioelectric response recorder(ABR-2000). Results : There are 23.4% in prevalence rate of migraine. The ratio of sex is M: F=1:17. The age of an attack is the highest in thirties. The patient are the most in forties. The mean duration of illness is 12.0±9.9 years. 83.4% had a family history. 61.1% had a moderate grade in severity of pain. 77.8% selected fatigue in induced cause of migraine. 69.4% had tingling sense, nausea and vomiting in the associated symptoms. 91.7% used analgesics for treatment and 51.5% of them used analgesics voluntarily. 61.9% of them take analgesics less than once in a week. 33.6% had the phlegm syncope headache in differentiation of syndrome. In ABR-2000 results, item of graph showed low tendency mostly. Conclusions : We expected that this re port of clinical progress, differentiation of syndromes and ABR-2000 results in migraine would be used basic data by oriental medicine to treat migraine.

경북 최초의 신장이식 1례

이중현,김용섭,이정호,이창우,김상욱,이문섭,오민구,하달봉,이경섭 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

신장이식은 환자의 삶의 질을 높이고 거의 정상적인 사회생활을 가능하게 함으로써 말기신부전 환자의 3가지 신대체 요법(혈액투석, 복막투석, 신장이식) 중에 가장 효과적이고 각광받는 치료법이라 할 수 있다. 최근 들어 의료기술과 의학의 발달로 신장이식의 성공률은 과거에 비해 비약적으로 높아지고 있으며 국내에서도 점차 신장이식수술을 받는 환자가 증가하고 있으나 서울이나 다른 대도시에 비해 의료환경이 열악한 중소도시나 지방의 병원에서는 아직도 시행하지 못하고 있는 형편이다. 이에 저자들은 경북 최초로 자체 의료진에 의해 고혈압과 말기 신부전으로 동국대 포항병원에서 혈액투석을 받고 있던 32세의 남자환자에게 부인으로부터 신장을 제공받아 신장이식을 성공적으로 시행하였기에 문헌고찰과 함께 보고하고자 한다. Kidney transplantation is the preferred treatment modality for many patients with end-stage renal disease (ESRD), because it offers improved quality of life over both hemodialysis and peritoneal dialysis. Patients who do well after transplantation generally report improvement in vitality and freedom to return to the style of life that they experienced before their progression to ESRD. Recently, the success rate of kidney transplantation is greatly being increased as the surgical technique and immunosuppressive drugs are developed. Kidney transplantation is also popular in Korea which has good result. But, until now the general hospitals which are located at small city can't try the kidney transplantation because they don't have proper facilities and experts. We firstly experienced a case of kidney transplantation in a 32 years old man with hypertension and chronic renal failure at KyoungBuk province. So we report this case with references.

악성흑색종과 양성멜라닌세포성모반에서 bcl-2 단백발현에 관한 면역조직화학적 연구

이성열,이종석,김현조,정현,조현듯,김의한 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background: The bcl-2 protein, contrast to p53, has been shown to be suppress the apoptosis, and overexpression of the bcl-2 protein has been reported in several malignant tumors. Although how the bcl-2 protein takes part in tumorigenesis has not been proved, the bcl-2 positive tumors appeared to have good prognosis in some malignant tumors. The expression pattern of the bcl-2 in melanocytic nevi and malignant melanoma have not been well known. The authors analyzed immunohistochemically expression of the bcl-2 protein to investigate the role of the bcl-2 protein in developing malignant melanoma. Method: 10 malignant melanoma and 10 benign melanocytic nevi were immunostained with anti-bcl-2 monoclonal antibody. Results: In malignant melanoma, 1 case was 2+ positive, 9 cases were 3+ positive. In benign melanocytic nevi, 2 cases were 2+ positive, 8 cases were 3+ positive. Conclusion: Bcl-2 protein is expressed by benign melanocytic nevi and malignant melanoma. There is no difference of bcl-2 protein expression in melanocytic nevi and malignant melanoma.

세로토닌성 항우울제가 백서의 Schedule-Induced Polydipsia에 미치는 영향

이기철,이정호,박중섭,최영민,전성일,정홍경,하준명,정재현 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

Object : Schedule-induced polydipsia is considered as an animal model of obsessive-compulsive disorder inrats. The authors evaluated the chronic effects of fluoxetine and clomipramine as serotonergic antidepressants and haloperidol as dopaminergic antagonist on the schedule-induced polydipsia in rat.Methods : Spraque-Dawley rats weighing 200-250gm were individually housed, maintained and allowed free access to water for 1 week. And then the rats were placed on a restricted diet. To induce polydipsia, rats were placed in automatic cage where a pellet dispenser automatically dispensed 90mg pellets on a fixed-time 60 seconds(FT 60s) feeding schedule over 150-minute test session for a day. Water was available at all times during the feeding schedule in automatic cage. After 4 weeks of daily exposure to the FT 60s feeding schedule, experimental rats met a predetermined criterion for polydipsic behavior(greater than 3 times of water per session on average). 4 groups of rats were administered fluoxetine(5mg/kg/i.p.), clomipramine(5mg/kg/i.p.), haloperidol(0.1mg/kg/i.p.), vehicle(1cc/kg/i.p.) for 3 weeks. Rats were tested once a week to access schedule induced polydipsic behavior. The chronic effects of experimental drugs on schedule induced polydipsic behavior were analyzed with repeated analysis of variance and Scheffe test as a post-hoc comparison.In order to measure water consumption in non-polydipsic food-deprived rats, a separate group of rats(N=8) were individually housed and given a single bolus(14.5 gm) of food per day which maintained them at their average body weight.Results and Conclusion : The results were as follows ;1) After 4 weeks of daily feeding procedure with fixed time schedule for 60 seconds per day, the experimental group showed significant differences than the control in the amount of water consumption as compared with their baseline water intakes. At the same periods, there were no differences between the experimental group and the control in body weight. 2) The clomipramine treated group and the fluoxetine treated group showed significant decrease in the amount of water intake as compared with their baseline of polydipsic water intakes for 3 weeks of treatment. However, the haloperidol treated group and the vehicle control group showed no changes of amounts of water intake for 3 weeks of treatment as compared with their baseline of polydipsic water intakes. 3) At 2 weeks of drug treatment, clmipramine treated group(16.88±6.51ml) and the fluoxetine treated group(22.50±10.35ml) showed significantly lower amounts of water intake than the haloperidol treated group (41.25±7.06ml) or vehicle control group(37.50±12.54ml). And also the clomipramine treated group(13.75±5.18ml) and the fluoxetine treated group(18.75±3.54ml) showed significantly lower amounts of water intake than the haloperidol group(35.00±11.65ml) and the vehicle control(34.38±6.78ml) at 3 weeks of drug treatment. Above findings suggest that the fixed time feeding procedure for schedule-induced polydipsia as an animal model of obsessive compulsive disorder was effective to the evaluation of pharmacological challenge study. The author confirmed that schedule-induced polydipsia was successfully decreased for 3 weeks of administration of clomipramine and fluoxetine but there was no response to haloperidol.

Application of Artificial Insemination Technology for Dairy Breeding in Mongolia

Hyun‐Tae Jo,Jong‐In Jin,Seong‐Su Kim,Byung‐Hyun Choi,Tumor Baldan,Jung‐Gyu Lee,Yun‐Shik Kim,Sam‐Churl Kim,Il‐Keun Kong 한국동물생명공학회(구 한국동물번식학회) 2011 발생공학 국제심포지엄 및 학술대회 Vol.2011 No.1

This study was focused on improvement of milk production in Mongolia dairy industry by artificial insemination (AI) technology, of which was supported from ODA project of KOICA in Republic of Korea. The study was started from January 2009 to present and 3rd years in this year. So, all data, especially synchronization and pregnancy of dairy cows (Holstein) will be summarized in final result in this year. For synchronization, total 81 dairy cows selected from 4 private farms that were 38, 30, 8 and 5 in Undarmal milk, Onjin (Enkhbayer), Jargalant, and BRM School, respectively. All the dairy cows were injected intramuscular (IM) of 5 ml PGF2α in the vulva and detected estrus 2 to 3 days after PGF2α injection. Total 78 out of 81 dairy cows (96.3%) were detected estrus by only 1 time injection of PGF2α. The dairy cows that were induced estrus, inseminated with 0.5 ml dairy frozen semen by conventional AI techniques. The pregnancy diagnosis of the AI dairy cows was detected by uterus palpation after 60 days of insemination. Total 75 from 78 inseminated dairy cows (90.1%) were diagnosis pregnant. The estrus induction and pregnant rate were very effective using PGF2α injection and conventional AI techniques in Mongolia dairy cow. The results indicated that AI after estrus induction in Mongolia dairy cows could be applied to dairy breeding technology to improve the breeding efficiency and milk production.

발열을 동반한 호중구감소증에서 Cefepime 단독투여와 Ceftazidime 및 Tobramycin 병합투여의 효능비교

정현욱,채제욱,강미라,양정채,문치숙,기현균,장현하,오원섭,김기현,백경란,이남용,송재훈 대한감염학회 2004 감염과 화학요법 Vol.36 No.6

목적 : 국내에서 발열을 동반한 호중구감소증이 있는 악성 종양환자에게 경험적 항생제로 베타락탐계 항생제와 아미노배당체의 병합요법의 사용이 일반적이다. Cefepime은 광범위 항균 작용을 가지고 있어, 그람 음성균 뿐만 아니라 그람 양성균에 대해서도 우수한 효과를 나타낸다. 재료 및 방법: 발열을 동반한 호중구감소증이 있는 악성 종양환자를 대상으로 무작위, 공개, 비교 연구를 시행하였다. 대상 환자를 무작위로 cefepime 단독요법군과 ceftazidime 및 tobramycin 병합요법군으로 나누어 투여하고 각각의 임상적 효능과 안전성을 비교하였다. 구강및 인후 점막염이 있는 환자에서 분리된 녹색 연쇄알 구균에 대한 항생제 내성 정도를 조사하였다. 결과 : 대상환자 89명 중 CA 투여군이 48예(53.9%), CT 투여군이 41예(46.1%)이었다. 발열의 유형별로 MDI는 18예(20.2%), CDI는 9예(10.1%), UF는 62예(69.7%)로 두 군 간에 차이가 없었다. CA 투여군과 CT 투여군의 임상적 호전률은 시험약 투여 후 2-4일째 각각 91.7%, 85.4% (P=0.31), 치료 종료 시 각각 91.7%, 100% (P=0.15)로 두 군간에 유의한 차이가 없었다. 치료 종료 시 CA 투여군과 CT 투여군의 세균학적 소실률은 모두 100%로 두 군간의 유의한 차이가 없었다(P=0.78). 점막염이 있는 환자로부터 녹색 연쇄알 구균이 분리된 경우는 25예(28.1%)이었으며, 분리된 녹색 연쇄알 구균은 penicillin, ceftriaxone, cefepime, vancomycin에 모두 감수성을 보였다. 약제 관련 이상 반응의 발생 빈도도 두 군간에 유의한 차이가 없었다. 결론 : 발열을 동반한 호중구감소증이 있는 악성 종양환자의 경험적 항생제로서 cefepime 단독요법은 ceftazidime 및 아미노배당체의 병합요법만큼 효과적이고 안전하였다. Background : Broad-spectrum antibiotic therapy has been recommended as an empirical regimen in cancer patients with febrile neutropenia. Cefepime is a fourth generation cephalosporin with good activity against both gram-positive cocci and gram-negative bacilli. Materials and Methods : To compare the efficacy and safety of cefepime alone with ceftazidime plus tobramycin as empirical regimen for adult cancer patients with febrile neutropenia, a randomized, open label, comparative trial was performed. If the patient showed clinical improvent 72 hours, antibiotic could be changed to oral ciprofloxacin. Clinical and microbiological responses were determined at 72 hours and at the end of therapy. To investigate the antimicrobial resistance of viridans streptococci, swab cultures were obtained from throat in all enrolled patients and antimicrobial susceptibility tests were performed by using microdilution method according to the NCCLS. Results : A total of 89 patients were enrolled. Forty-eight patients received cefepime alone (CA), and 41 patients received ceftazidime plus tobramycin (CT). Demographic and baseline clinical characteristics were similar in both groups (P>0.05). The initial clinical success rate at day 2-4 in group CA (91.7%) was similar with that in CT group (85.4%) (P=0.31). At the end of therapy, the final clinical success rate in CA group (91.7%) was similar to that in CT group (100%) (P=0.15). In 18 patients, with microbiologically defined infections, the eradication rate was 100% in both groups. Adverse events including liver dysfunction (21.3%) and renal dysfunction (2.2%), were similar in both groups (P=0.87). Viridans streptococci were isolated from the throat cultures in 25 cases, and all of these strains were susceptible to penicillin (MIC_(90) 0.12 ㎍/mL), cefepime (1 ㎍/mL), and vancomycin (0.12 ㎍/mL). Conclusion : Efficacy and safety of cefepime monotherapy was comparable to the combination of ceftazidime and tobramycin. It could be used as an alternative empirical regimen for treating cancer patients with febrile neutropenia.

중증 재생불량성빈혈에서 타인 혹은 HLA 불일치 혈연간 골수이식을 위한 cyclophosphamide와 antithymocyte globulin전처치 요법

이정희,이제환,김신,설미이,이정신,김우건,김상희,지현숙,박찬정,이규형 대한조혈모세포이식학회 2001 대한조혈모세포이식학회지 Vol.6 No.1

배경: Cyclophosphamide와 ATG의 전처치 요법은 HLA가 일치하는 형제간 골수이식에서는 매우 효과적인 것으로 알려져 있으나, 타인 혹은 HLA 불일치 혈연간 골수이식에서는 전처치 요법으로서 불충분한 것으로 보고되었는데, 주요 문제는 착상 부전이었다. 우리나라를 포함하는 극동아시아 지역의 국가들에서 발표되는 보고에 의하면 타인이식을 포함하여 골수이식 후 착상 부전과 이식편대숙주질환의 발생이 서구 국가들로부터의 보고에서보다 적은 것으로 알려져 있다. 저자 등은 6예의 중증 재생불량성빈혈 환자들에서 질병 초기에 Cyclophosphamide와 ATG만을 이용하여 전처치를 한 후에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행하였다. 방법: 1999년 5월부터 2000년 4월까지 서울중앙병원에서 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 성인 중증 재생불량성빈혈 환자들을 대상으로 하였다. 골수이식을 위한 전처치 요법으로 cyclophosphamide (50 mg/kg/d x 4)와 ATG (30 mg/kg/d x 3)를 투여하였는데, 골수이식 전에 ATG에 대하여 과민 반응을 보였던 한 예 (UPN 120)에서는 ATG 대신에 fludarabine (30 mg/m2/d x 3)을 투여하였다. 이식편대숙주질환의 예방을 위하여 cyclosporine과 methotrexate를 투여하였다. 결과: 연구 기간 중에 모두 6예가 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받았는데, 5예는 타인으로부터 골수를 공여 받았으며, 1예는 HLA의 표현형이 하나의 유전자좌에서 일치하지 않는 형제로부터 골수를 공여 받았다. 타인 골수이식을 받은 5예 중에서 3예의 공여자는 HLA의 표현형이 일치하였으며, 1예는 하나의 유전자좌가 major mismatch였고, 1예는 하나의 유전자좌가 minor mismatch였다. 추적기간의 중앙값은 406일 (범위, 328-643일)인데, 6예 모두에서 착상된 상태를 유지하면서 생존해있다. 2예에서 3도의 급성 이식편대숙주질환과 전신성 만성 이식편대숙주질환이 발생하였다. 결론: Cyclophosphamide와 ATG의 전처치 요법은 재생불량성빈혈의 초기에 타인 혹은 HLA 불일치 혈연간 골수이식을 시행 받은 한국인 환자들에서 충분히 착상을 가져올 수 있는 요법으로 생각된다. 비록 본 연구의 대상 환자 수가 적지만 결과는 매우 고무적이다. HLA가 일치하는 형제가 없는 중증 재생불량성빈혈 환자의 경우에 타인 골수 공여자에 대한 검색을 조기에 시행해야 하며, 타인 혹은 HLA 불일치 혈연간 골수이식을 질병 초기에 적극적으로 고려해야 할 것으로 생각된다. Background: Cyclophosphamide (CY) and ATG regimen was reported to be insufficient for alternative donor BMT in SAA patients due to high incidence of graft rejection. The rates of graft rejection and GVHD after allogeneic BMT including unrelated donor transplants seemed to be lower in reports from Asian countries of Far East. We applied CY/ATG regimen to six patients with early stage of SAA transplanted with marrow from alternative donors other than HLA-identical siblings. Methods: Three patients were transplanted from HLA-phenotypically identical unrelated donors, two from one-locus mismatched unrelated donors, and one from an one-locus mismatched sibling donor. Four patients received no previous therapy for SAA, and two received one course of immunosuppressive therapy with ATG. Preparative regimen was CY (200 mg/kg) plus ATG (90 mg/kg) in all patients except one who had had an anaphylactic reaction to ATG prior to BMT and received fludarabine (90 mg/m2) in place of ATG. Cyclosporine plus methotrexate were given for GVHD prophylaxis. Results: All six patients engrafted and all are alive with durable engraftment at a median follow-up of 406 days (range, 328 to 643). Two patients developed grade III acute GVHD and extensive chronic GVHD. Conclusions: CY/ATG regimen may be sufficient in Korean patients with early stage of SAA transplanted with marrow from alternative donors. Although the number of patients in present study is small, results are encouraging. Stem cell transplantation using alternative donors may be considered at early stage of aplastic anemia.