대장선암 조직의 CEA에 관한 면역조직학적 고찰

권오준,신현호,서인수,손태중 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.4

The autors immunohistochemically studied 63 cases of colorectal adenocarcinoma to evaluate clinical significance of histologic pattern of tissue CEA. Immunohistochemical stain of cancerous tissues was performed by ABC method, and then light and electron microscopy were carried out. On light microscopic studies, CEA was mainly distributed on apical and lateral surface of normal and cancer cells and weakly positive in the cytoplasm of cancer cells. On electron microscopic studies, CEA was strongly positive along the apical and lateral borders of cancer cells and weakly positive in the cytoplasm as a pattern of fine granules. The statistical studies revealed such a data that high preoperative serum CEA level was shown in cases of tumor necrosis. Also in groups of surrounding invasion, well differentiation, and distant metastasis of the cancer, preoperative serum CEA levels were significantly increased. Thus, the evaluatin of CEA serologically and immunocytochemically in cases of colorectal adenocarcinoma may significantly inform in diagnosis or postoperative treatment and follow-up.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

한국에서 분리한 사람 Caliviviruses의 RnA-dependent RNA Polymerase 유전자의 다양성

최종환,한동표,이현우,손준,김현원 연세대학교 원주의과대학 1997 원주의대논문집 Vol.10 No.1

간내담관암에 동반된 종양 색전에 의한 폐쇄성 황달

박준용,박경남,한동수,이광수,이민호,조윤주,최호순,이동후,손주현,손영우,기춘석,은창수,전용철,임현철,고병희,함준수,윤병철 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1

Tumor emboli of intrahepatic cholangiocarcinoma in bile duct rarely cause obstructive jaundice. Intraductal tumor embolus is associated with advanced stage of tumor within the liver, and shows poor prognosis and brief survival. However, jaundice by tumor embolus from intrahepatic cholangiocarcinoma must be distinguished from jaundice by common cause, which can be palliated safely and effectively. A patient presented with 1-month history of jaundice and epigastric pain. On cholangiography, polypoid filling defect was observed in the common hepatic duct, which had dilated proximal intrahepatic bile duct and mass shadow on the left lobe of liver. Tumor resection, embolectomy, and bile duct decompression were performed and the obstructive jaundice was relieved. Tumor embolus from intrahepatic cholangiocarcinoma was confirmed intraoperatively and pathologically as the cause of bile duct obstruction. In this report, we describe the rare case of obstructive jaundice by tumor emboli from intrahepatic cholangiocarcinoma with a review of literatures.

Independent dose validation system for Gamma Knife radiosurgery, using a DICOM-RT interface and Geant4

Choi, Hyun Joon,Chung, Hyun-Tai,Sohn, Jason W.,Min, Chul Hee Elsevier 2018 PHYSICA MEDICA Vol.51 No.-

<P><B>Abstract</B></P> <P>Leksell GammaPlan was specifically designed for Gamma Knife (GK) radiosurgery planning, but it has limited accuracy for estimating the dose distribution in inhomogeneous areas, such as the embolization of arteriovenous malformations. We aimed to develop an independent patient dose validation system based on a patient-specific model, constructed using a DICOM-RT interface and the Geant4 toolkit. Leksell Gamma Knife Perfexion was designed in Geant4.10.00 and includes a DICOM-RT interface. Output factors for each collimator in a sector and dose distributions in a spherical water phantom calculated using a Monte Carlo (MC) algorithm were compared with the output factors calculated by the tissue maximum ratio (TMR) 10 algorithm and dose distributions measured using film, respectively. Studies using two types of water phantom and two patient simulation cases were evaluated by comparing the dose distributions calculated by the MC, the TMR and the convolution algorithms. The water phantom studies showed that if the beam size is small and the target is located in heterogeneous media, the dose difference could be up to 11%. In the two patient simulations, the TMR algorithm overestimated the dose by about 4% of the maximum dose if a complex and large bony structure was located on the beam path, whereas the convolution algorithm showed similar results to those of the MC algorithm. This study demonstrated that the in-house system could accurately verify the patient dose based on full MC simulation and so would be useful for patient cases where the dose differences are suspected.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The Geant4 model of Gamma Knife treatment and its validation are presented. </LI> <LI> The clinical application of the Geant4 model of Gamma Knife is provided. </LI> <LI> The necessity of an independent patient dose validation system is presented. </LI> </UL> </P>

Swyer - James 증후군 1 례

손명현(Myung Hyun Sohn),강혜영(Hye Young Kang),김규언(Kyu Earn Kim),이기영(Ki Young Lee),정병주(Byung Ju Jeoung),정재준(Jae Joon Chung),김명준(Myung Joon Kim) 대한소아알레르기호흡기학회 1996 소아알레르기 및 호흡기학회지 Vol.6 No.1

Swyer-James syndrome consists of an abnormal radiolucency of one lung or lobe, secondary to obliterative bronchiolitis with distal air trapping. In 1953, Swyer and James first described the syndrome as unilateral pulmonary emphysema in a six-year-old patient. Other causes of this finding, such as an obstruction of a major bronchus by a foreign body, a large emphysematous bulla, compensatory expansion, or congenital lobar emphysema must be ruled out. We have experienced a case of idiopathic unilateral hyperlucent lung which was confirmed by chest roentgenography, chest computer tomography, lung perfusion scan, pulmonary arteriography and bronchography in a patient. A brief review of related literature was presented.

Production of monoclonal antibodies for Plasmodium vivax lactate dehydrogenase and patient sera screening using sandwich ELISA.

Kim, Jong-Hyun,Lee, Jinyoung,Sohn, Hae-Jin,Song, Hyun-Ok,Kim, Jung-Yeon,Lee, Won-Ja,Park, Hyun,Shin, Ho-Joon Springer International 2012 Parasitology research Vol.111 No.4

<P>Malaria is a worldwide infectious disease. There are many diagnostic kits to detect malaria infection. However, the sensitivity of these diagnostic kits remains a problem. To develop a diagnostic kit for malaria that has high sensitivity, it is necessary to produce monoclonal antibodies (McAbs) with high affinity. The present study was undertaken to produce hybridoma cells that can be used to generate McAbs with high affinity and specificity against Plasmodium vivax lactate dehydrogenase (pvLDH). In this study, BALB/c mice were immunized with purified recombinant polypeptides that encode pvLDH. McAbs against pvLDH were produced according to the protocol of hybridoma technique using myeloma cells (SP2/0 cell lines). The McAbs were characterized by isotyping and by Western blot analysis. Two McAbs (D2H and D7E) against pvLDH antigen were obtained. The isotypes of D2H and D7E were IgG2b. They recognize 33 kDa proteins that were defined as pvLDH by Western blot analysis. In the affinity test, D2H and D7E showed positively optical density value until each McAbs were serially diluted at concentrations of 0.156 and 0.078 μg/ml, respectively. To evaluate sensitivity and specificity against clinical specimens of P. vivax, purified McAbs were tested with alkaline phosphatase-conjugated monoclonal antibodies and blood samples (n = 180) of P. vivax patients using the sandwich enzyme-linked immunosorbent assay, showing the 98% sensitivity. We suggest that McAbs produced in this study may be used for developing efficient and rapid diagnostic kits.</P>

소화기 ; 만성 간질환에서 펜넬의®무작위, 이중맹검, 다기관 제4상 임상시험

김형준 ( Hyung Joon Kim ),이준성 ( June Sung Lee ),이현웅 ( Hyun Woong Lee ),김문영 ( Mun Young Kim ),남순우 ( Soon Woo Nam ),손주현 ( Ju Hyun Sohn ),조세현 ( Se Hyun Cho ),윤승규 ( Seung Gyu Yoon ),양진모 ( Jin Mo Yang ),박충기 ( 대한내과학회 2014 대한내과학회지 Vol.86 No.2

목적: 펜넬(Pennel(R))은 DDB에 마늘유(garlic oil)를 복합시킨 제제로 혈청 트랜스아미나제(AST와/또는 ALT)가 상승된 만성 간 질환자에서 펜넬의 치료 효과에 대한 유효성을 검증하기 위해 활성대조약인 레가론, 위약군과 비교 평가한 다 기관 제 4상 임상연구를 실시하였다. 방법: 총 11개 병원, 237명의 피험자가 연구에 참여하였다. 이 중 시험약군은 100명, 활성대조군은 102명, 위약군은 35명이었다. 12주간의 치료기간 동안 순응도는 좋았으며 중도 탈락은 없었다. 환자의 연령은 평균 46세, 남성의 비율이 높았다. 치료 전 ALT 값은 91 U/L였으며 66%가 비알코올성 지방간염, 15%가 알코올성 간염, 12%가 만성 C형간염 그리고 7%가 만성 B형간염 환자였다. 결과: 약물 투약 12주째 ALT 정상화 분율은 시험약군이 89명으로 89%, 활성대조군이 19명으로 18.6%, 위약군이 8명으로 22.9%로 나타났다(p < 0.001). 간염의 원인에 따른 분류에서도 시험군에서 통계적으로 의미 있게 ALT 정상화 분율의 비율이 높았다. 치료 전 대비 치료 12주의 ALT는 시험약군에서 평균 85 U/L 감소하였으나 활성대조군은 20 U/L, 위약군은 25 U/L 감소하였다. 항산화 효과 지표인 malondialdehyde(MDA)는 시험약군에서만 1.4 pmol/mg의 호전을 보였다. 하위그룹분석에서 비알코올성 지방간염과, 바이러스성 간염 환자에서 의미 있게 MDA 수치의 호전을 보였다(p < 0.001). 시험약물의 안전성 평가에서도 이상반응의 발생빈도가 위약군에 비해 차이가 없었다. 이상반응의 대부분은 감기, 피로, 설사 및 소화불량 등 grade 1의 경증이었으며 중대한 이상반응은 없었다. 삶의 질 평가 총점수도 시험약군이 치료 12주에 10점 이상 통계적으로 의미 있게 증가하였다(p < 0.001). 결론: 결론적으로 ALT가 상승한 만성 간 질환자를 대상으로 한 12주간의 펜넬 4상 임상 시험의 유효성과 안전성 평가에서 펜넬은 원인 질환과 무관하게 치료 4주 만에 급격한 ALT 수치의 정상화를 유도하였으며 항산화 효과를 보였다. 치료기간 동안 부작용이 거의 없는 안전한 약제로서 순응도가 뛰어났으며, 치료 후 삶의 질이 의미 있게 개선되는 효과를 보였다. Background/Aims: Biphenyl dimethyl dicarboxylate (DDB) combined with garlic oil (pennel) has been used to treat chronic liver disease. A randomized, double-blind, active- and placebo-controlled clinical trial was conducted to investigate the efficacy, safety and quality of life in chronic liver disease patients. Methods: A total of 237 patients with chronic liver disease were randomized into three groups; 100 patients were administered pennel, 102 patients Legalon as an active-control and 35 patients placebo for 12 weeks. The primary endpoint was the rate of alanine aminotransferase (ALT) normalization. We assessed differences in ALT levels and malondialdehyde (MDA) as an oxidative biomarker between 0 and 12 weeks, the improvement in quality of life using a chronic liver disease questionnaire (CLDQ) and the incidence of adverse events. Results: Among 237 patients, there were 157 patients with non-alcoholic fatty liver disease, 36 patients with alcoholic liver disease, and 28 patients with chronic hepatitis B and C. The incidence of ALT normalization at 12 weeks was 89% for the pennel group, 18.6% for the active-control group, and 22.9% for the placebo-control group (p < 0.001). The difference in serum ALT level between 0 and 12 weeks was significantly higher in the pennel group (p < 0.001) and the level of MDA was decreased in the pennel group, statistically (p < 0.001). There was no difference in incidence of adverse events among groups. The pennel group showed significant improvement based on the CLDQ (p < 0.001). Conclusions: Pennel can effectively improve the rate of ALT normalization and the quality of life with a safety profile in chronic liver disease. (Korean J Med 2014;86:179-189)

정신분열병 환자에 대한 통합심리치료의 효과

이만홍,이희상,조현상,현명호,안석균,유상우,박지환,한승진,현용호,구민성,손석한,김세주,이현주,박소라,송선미,안혜리,최정아,남궁기,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

목 적: 본 연구는 인지재활이 강화된 통합심리치료를 정 신분열병 환자에게 시행하여 그 결과를 평가하고 행상의 문제점을 분석하여 정신분열병 환자의 재활을 위한 한국형 통합심치료를 개발하기 위한 목적으로 실시되었다 . 방 법. 정신분열병으로 입원한 환자에게 인지분화,사회지각, 언어소통,사회기술, 문제해결기술의 5단계 구성된 통합심리치료를 12주간 주3회 실시하였고 치료 전후에 저자들이 개발한 인지분화평가척도, 사회기술평가척로,문제해결기술척도와Positive And Negative Syndrome Scale로 치료효과를 평가하였다. 집단내의 상호작용과 사회적 관심과 같은 비특이적인 간섭변인을 배제하기 위하여 정신건강교육에 의한 관심 -위약 대조군을 설정하여 비교하였다. 결 과: 통합심리치료를 시행한 군은 대조군에 비해 일반정신병리점수와 임상중상 총점수의 유의미한 호전이 있었고 인지기능의 호전은 인지분화 소프로그램후에서만 관찰되었으며 사회기술 소프로그램후의 사회기술기능은 제한적 효과만 있었다. 그러나 통합심리치료 시행군내에서는 12주후 양성증상. 음성증상. 일반 정신병리 모두에서 호전되었다. 결 론: 본 결과는 통할심리치료가 정신분열병 환자에게 임상 중상 영역의 치료효과가 있음을 지지하지만 인지 영역 훈련이 갖는 특정 효과는 보여주지 않았다 한편으로는 치료 프로그램의 사회문화적이고도 언어적인 배경의 차이. 치료기간, 집단구성원의 기능 동질화, 정서 처리, 인지영역 훈련에 대한 치료자의 숙련도 등의 시행상의 문제가 있어 우리나라 환자에의 적용을 위해서는 통합심리치료 원저의 수정이 요구된다. 0bjectives : This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. Methods : Cognitive Differentiation Scale, problem-Solving Scale, and PANSS(Positive And Negative Syndrome ScalE) were administered to schizophrenic inpatients before and after IPT incorporating cognitive diffirentiation, social perception, verbal communication, social skill and interpersonal Problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. Results : The 12-week IPT groups, compared with the control groups, demonstrated sign-nificant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only artier cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology werc found. Conclusion : These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists'skill in the training of cognitive components. So the modification of this modality will be required.

궤양성 대장염과 유사한 양상을 보인 살모넬라 대장염 1예

손병관,한동수,은창수,박준용,이오영,전용철,손주현,윤병철,함준수 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.1

Salmonella species have recently been shown to involve the colon in a fashion resembling ulcerative colitis by radiographic and endoscopic appearance. The presentation of Salmonella colitis is usually similar to that of ulcerative colitis; and often leads to delayed or inappropriate management. Furthermore, Salmonella infection and inflammatory bowel disease (IBD) can coincide in the same patient. Salmonella colitis in the setting of undiagnosed underlying IBD can present a diagnostic dilemma for the clinician. We report a case of Salmonella colitis in which the radiographic and colonoscopic findings were similar to those of ulcerative colitis.