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      • 바터 팽대부에 생긴 유암종 1예

        강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

        Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.

      • 간세포암의 고주파 열치료 후 천자침 경로를 통한 전이 1례

        조영완,박석주,진한영,김준영,이재익,강명주,박정하,윤정희,박성재,지삼룡,이연재,이상혁,설상영 인제대학교 2006 仁濟醫學 Vol.27 No.-

        Radiofrequency ablation(RFA), as a form of minimally invasive therapy for hepatocellular carcinoma, has become an important treatment modality. Because of limitation of surgery, RFA has become standard therapy for hepatocellular carcinoma in some situations. But there are some complications of RFA such as bleeding, infection, hematoma, adjacent organ thermal damage including intestinal perforation, needle track seeding, and so on. There are few reports in the literature that systematically evaluate the incidence of needle tract seeding and its associated risk factors. And only 2 cases of needle tract seeding of hepatocellular carcinoma after RFA were reported in Korea. We report a case of needle tract seeding of hepatocellular carcinoma after RFA.

      • RAW264.7 세포에서 interferon-r 및 LPS에 의해 유도되는 NO생성에 미치는 TALT-35의 영향

        박종일,박경석,김종석,박지훈,윤은진,송경섭,서강식,김훈,윤완희,박승길,임규,황병두 충남대학교 생물공학연구소 2006 생물공학연구지 Vol.12 No.-

        TALP-35 purified from human term placenta is known to increase microtubule polymerization and stabilize the polymerized microtubule. To examine the effect of TALP-35 on immune system this study was performed. MTT assay was performed to investigate the effect of TALP-35 on the proliferation of RAW264.7 cells. TALP-35 dose dependently suppress the proliferation of RAW264.7 cells at high concentration (above 1 μM) in unstimulated cells, in case of 10 μM TALP-35 treated cells the suppression was 25% but in stimulated cells it was only 15%. Cosedimentation assay was carried out to investigate whether TALP-35 can bind to tubulin of RAW264.7, monocyte/macrophage lineage of mouse, and polymerize it. TALP-35 polymerize the tubulin of RAW264.7 cells and sedimented in dose-dependent manner. To investigate the effect of TALP-35 on the expression of iNOS protein western blotting was performed. The expression level of iNOS was decreased dose dependently in high concentration of TALP-35 treatment. To examine the activity of iNOS, secreted NO was determined by method based on Griess reaction. Interferon-γ and LPS-stimulated production of NO from RAW264.7 cells was decreased dose dependently above 0.1 μM concentration of TALP-35 and 50% is decreased at 10μM of it. This study shows TALP-35 can control cytokine induced-iNOS expression therefore it might control inflammatory diseases.

      • 회맹장 판막에 발생한 아니사키스증 1례

        이재익,박정하,김준영,조영완,진한영,강명주,정은욱,박석주,양성연 인제대학교 2006 仁濟醫學 Vol.27 No.-

        Anisakiasis refers to parasitic infestation by nematode larvae that belongs to the subfamily Anisakinae, and this condition is seen in people who eat inadequately prepared or raw salt-water fish. While gastric anisakiasis is commonly diagnosed by endoscopic technique, intestinal anisakiasis is rare because it is less common and the clinical and radiologic features are poorly understood. The authors report a case of human anisakiasis involving the ileocecal valve in 62-year-old man who had the history of eating raw cuttlefish.

      • KCI등재후보

        시험관내 심내막염 모델에서 Methicillin 내성 포도구균에 대한 Vancomycin, Arbekacin, Gentamicin 단독 혹은 병합효과

        이동건,전혜선,임동석,최수미,최정현,유진홍,신완식,강문원 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

        목적 : Methicillin 내성 포도구균(methicillin resistant Staphylococcus aureus, MRSA)은 병원감염의 중요한 원인균으로 vancomycin이 선택약제이다. 그러나 심내막염 등의 중증감염에서는 vancomycin의 치료실패와 함께 최근 내성균도 증가하고 있어 vancomycin을 대체할 수 있는 항균제와 보다 효과적인 항균요법의 개발이 필요하다. 본 연구에서는 사람의 환경과 유사한 시험관내 감염 모델을 적용하여 MRSA 치료를 위한 vancomycin, arbekacin, gentamicin의 단독 및 병합효과를 비교하였다. 방법 : 임상에서 분리된 MRSA 2균주(GRI 53, gentamicin 내성 : GS171, gentamicin 감수성)로 fibrin clot을 제작하여 시험관내 심내막염 모델을 만들어 vancomycin, arbekacin, gentamicin을 단독 혹은 병합주입하였다. 반감기와 최고 및 최저농도는 사람의 약동학을 기준으로 하였다. Vancomycin은 6, 12, 24시간마다 주입하거나 24시간 연속주입하였고 arbekacin은 12, 24시간마다, gentamicin은 8, 24시간마다 주입하였다. 병합주입의 경우 vancomycin은 12시간마다, gentamicin, arbekacin은 24시간마다 투여하였다. 각 투여군의 살균효과는 0, 8, 24, 32, 48, 72시간째의 fibrin clot내 집락수로 측정하였다. 결과 : GRI153에 gentamicin을 주입한 군 이외의 모든 실험군에서 대조군에 비해 의미있게 fibrin clot내 집락수가 감소하였다(P<0.001). Vancomycin과 arbekacin 단독주입군내서 8시간째의 집락수는 GRI153보다 GS171에서 의미있게 낮았고(P=0.02), GS171에 arbekacin 12시간마다 투여한 군의 집락수가 가장 낮았다(P=0.01). 72시간째 집락수는 균주의 종류나 vancomycin 혹은 arbekacin의 투여간격에 따른 차이가 없었다. GRI153에서 vancomycin과 arbekacin의 병합주입군은 24시간까지 상가작용이 있었으나 vancomycin과 gentamicin 병합주입에서는 무관작용이었고 GS171에서도 72시간 동안 무관작용을 보였다. 또한 전 실험기간 동안 내성균은 발현되지 않았다. 결론 : 시험관내 심내막염 모델에서 MRSA에 대한 arbekacin의 항균력은 vancomycin과 유사하여 단독주입이 가능함을 시사한다. Gentamicin 내성균주의 경우 두가지 항균제의 병합주입으로 24시간까지 상가작용을 보이고 있으나 임상에 적용하기 위해서는 추가연구가 필요할 것으로 생각된다. Background : Glycopeptide has been used for the one-and-only treatment of choice in methicillin resistant Staphylococcus aureus (MRSA) infection, but its exclusive use for the MRSA infection has led to the increased risk of glycopeptide-resistance. To find an alternative (s), we employed an in vitro infective endocarditis model (IVIEM) to compare the efficacy of vancomycin (VCM). arbekacin (ABK), and gentamicin (GM) alone or in combination. Methods : Using two strains of clinically isolated MRSA, one GM susceptible (GS171) and the other GM resistant (GR153), fibrin clots were prepared and suspended in IVIEM. Antibiotics were added as a bolus to simulate human pharmacokinetics of regimens, including q 6 h, q 12 h, q 24 h, or continuous infusion with VCM, q 12h or q 24 h with ABK, and q 8 h or q 24 h with GM. In cases of combination, regimens were VCM q 12 h plus ABK q 24 h, and VCM q 12 h plus GM q 24 h. Fibrin clots were removed from each model at 0, 8, 24, 32, 48. and 72 h, and the bacterial densities (in CFU/g) were determined. Results : At 8 hour, the colony counts of GS171 were lower than those of GR153 (P=0.02), and the lowest with the ABK q12h against GS171 (P=0.01). At 72 hour, monotherapy with ABK or VCM produced same degree of bacterial reductions in IVIEM, regardless of dosing frequency or GM-resistance. In the case of GM-resistance, combination of VCM and ABK did show additive effect until 24 hours, although VCM and GM showed no indifference during all the experiments. Development of resistance during experiment was not observed with any regimens. Conclusions : Our data suggest that ABK monotherapy could be used as an alternative to VCM even in the treatment of GM-resistant staphylococcal endocarditis. Further studies will clinical trials are warranted to evaluate the additive effect of VCM and ABK.

      • 모 컴퓨터 회사 근로자 건강증진 사업 전개를 위한 수요조사

        임현우,안병용,최환석,박정일,김경수,이강숙,김정아,구정완 가톨릭대학산업의학쎈타 산업의학연구소 1997 韓國의 産業醫學 Vol.36 No.4

        Before conducting the health promotion program, we surveyed the health risk appraisal(HRA) of 210 workers (186 men and 24 women) in a computer company, for the need assessment, selection of target population, priority setting, and as a standard for comparision after performing the program. The smokers were 115(88.6%), and drinkers (over 1 bottle of Soju per week) were 91(44.8%) in men. Entire women and 148(78.0%) men never or irregularly exercise. Type A personality were 73(39.2%) in men, 8(33.3%) in women, and 26(14.0%) of men and 6(25.0%) of women were high stress risk group. 53(25.2%) of men and 2(8.3%) of women were obese (BMI ≥25kg/m²), and workers who consumed exess of total calory compared with recommendation were 142(76.3%) in men and 18(75%) of women. By the health risk appraisal, it was suggested that smoking cessation program, drinking counselling, exercise prescription, stress management, and weight control program should be conducted effectively for the high risk group.

      • Multiple myeloma 환자에서 Bortezomib치료 후 발생한 마비성 장폐색증 1례

        김준영,이원식,손창학,박성길,진한영,박석주,조영완,정은욱,강명주,박정하,주영돈 인제대학교 2006 仁濟醫學 Vol.27 No.-

        Bortezomib is the first clinically available proteasome inhibitor that is clinically effective in the treatment of multiple myeloma. A proteasome inhibitor acts through multiple mechanisms to arrest tumor growth, tumor spread, and angiogenesis. The main adverse effects of bortezomib are gastrointestinal symptoms, cytopenia, fatigue, and peripheral neuropathy. To date, severe paralytic ileus has not been reported as a toxic effect of bortezomib treatment in multiple myeloma. Bortezomib is a novel agent that has only been used clinically for 30 months, so a need exists to further evaluate its toxicity. We report a case of grade Ⅲ (NCI CTCAE v3.0) or grade Ⅳ(SWOG toxicity criteria) paralytic ileus in a 65-year-old man with relapsed multiple myeloma who underwent one cycle of single-agent bortezomib treatment scheduled in a 21-day cycle (1.3 mg/㎥ as a single i.v. bolus on days 1, 4, 8, and 11).

      • Evaluation of hepatotoxicity of chemicals using hepatic progenitor and hepatocyte-like cells derived from mouse embryonic stem cells: effect of chemicals on ESC-derived hepatocyte differentiation.

        Kang, Seok-Jin,Jeong, Sang-Hee,Kim, Eun-Joo,Cho, Joon-Hyoung,Park, Young-Il,Park, Sung-Won,Shin, Hyo-Sook,Son, Seong-Wan,Kang, Hwan-Goo Princeton Scientific Publishers 2013 Cell biology and toxicology Vol.29 No.1

        <P>Embryonic stem cell testing is an alternative model system to assess drug and chemical toxicities because of its similar developmental characteristics with in vivo embryogenesis and organogenesis. This study evaluated the toxicity of chemicals at specific developmental stages of mouse embryonic stem cell (ESC)-derived hepatic differentiation; hepatic progenitor cells (HPCs), and hepatocyte-like cells (HCs). The toxic effects of carbon tetrachloride (CCl(4)), 5-fluorouracil (5-FU), and arsanilic acid (Ars) were evaluated by measuring the expressions of Cytokeratin (CK18) and GATA binding protein 4 (GATA-4) and the activities of aspartate transaminase (AST), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) during the hepatic differentiation process. Non-toxic doses of three chemicals at a range of 25 to 500?μM for CCl(4), 12.5 to 800?nM for 5-FU and 6.25 to 400?mM for Ars were treated. In the CCl(4)-treated group, significant decreases (P?<?0.05) of the marker expression were observed by more than 300?μM from day 10 in CK18 and by more than 400?μM of CCl(4) from day 22 in GATA-4, respectively. However, both markers were decreased (P?<?0.01) by treatments of all doses at day 40. In the 5-FU-treated group, the expressions of two proteins were not affected by any of the doses at day 10 and 22, whereas the GATA-4 expression was decreased (P?<?0.05) by more than 400?nM of 5-FU at days 28 and 40. In the Ars-treated group, the CK18 expression was inhibited (P?<?0.05) by more than 100?mM of Ars at day 22 but showed a tendency to recover. Although the GATA-4 was inhibited by all doses at day 22, the inhibition of GATA-4 recovered at days 28 and 40. ALP activities of three chemicals were significantly increased (P?<?0.05) by a dose-dependent manner. The activities of AST and LDH were prone to be increased by more than 300?μM of CCl(4,) but not affected by all doses of 5-FU except for 800?nM of 5-FU in AST activities. In the Ars, the enzyme activities were significantly increased (P?<?0.05) by more than 50?μM of Ars in AST and more than 6.25?μM of Ars in LDH. The present results indicate that CCl(4) has a more toxic effect on HCs, whereas Ars is more toxic to HPCs. Additionally, in vitro alternative testing using ESC-derived HPCs and HCs could provide useful information on chemical toxicity during the hepatic differentiation process and could be a useful model system for assessing chemical hepatotoxicity.</P>

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