위암환자의 복강내에 투여한 Mitomycin C-Carbon Particle의 Mitomycin 용출에 관한 연구

노승무,조영훈,정경수,오정연,김진향,양준묵,강대영,송규상,조준식,최선웅,이진호,민병무,김용백,김창식,박근성,인현빈,정현용,김학용 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Locoregional recurrence is the most common type of recurrence in surgical operation of gastric adenocarcinoma, and peritoneal dissemination is one of the most difficult problems in advanced gastric adenocarcinoma treatment. Because the peritoneal cavity is the most common site of the first recurrence after gastric cancer resection, intraperitoneal chemotherpy seems a logical choice for cancer chemotherapy. The Mitomycin C(MMC) adsorbed by the activated charcoal particles(CH) is relatively released when the drug concentration surrounding the carbon particles becomes low in the peritoneum of the peritoneal cavity. For the intraperitoneal chemotherapy on the advanced gastric adenocarcnoma, mitomycin C adsorbed on activated carbon particles was administered in the peritoneal cavity just before abdominal wall closure. The closed drainage tubes were inserted in the peritoneal cavity and clamped for tuo hours after completion of operation. MMC concentrations were serially measured in peritoneal fluid, plasma and urine at 2hour, 48 hour, 72 hour and 168 hour following its administration in order to study the efficacy of the MMC-CH as a drug delivery system. There were minimal toxicities in born marrow, liver, and gastrointestinal system after intraperitoneal MMC-CH administration. The data of this study suggested that MMC-CH may have a somewhat more beneficial effect than surgery alone when administered in optimal dose and schedules, but the MMC concentration of the peritoneal fluid was not sufficient to eradicate remnant cancer cells, and effective duration of maintenance was only below 24 hours in the peritoneal fluid and plasma.

Rat의 복강에 삽입한 Filorouracil-Polyglycolic acid제형의 Fluorouracil용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitioneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adenocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

Rat의 복강에 삽입한 Fluorouracil-Polyglycolic acid 제형의 Fluorouracil 용출에 관한 연구

노승무,정경수,오정연,김진향,양준묵,강대영,송규상,최정목,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 忠南大學校 癌共同硏究所 1998 癌共同硏究所 硏究誌 Vol.2 No.1

A common form of relapse in adenocarcinoma of the stomach is intraperitoneal dissemination, in fact, among gastric adenocarcinoma patients who have undergone surgery intended to cure, approximately 50% of the patients develope initial recurrence in the peritoneal cavity regardless of the anatomic site of the primary tumor within the stomach. The efficacy of systemic postoperative chemotherapy to prevent peritoneal recurrence of gastrric adcnocarcinoma is not satisfactory. There is still a great need for improved therapeutic strategies on the disseminated microscopic disease and small miliary nodules remaining on the peritoneal surface or lymphatics after operation. The authers have made fluorouracil-polyglycolic acid composite disks(Fu-PGA disks) with fluorouracil and biodegradable polymer: polyglycolic acid for more effective intraperitoneal chemotherapy. We inserted the Fu-PGA disk(s) in the peritoneal cavity of rat and pharmacokinetic study was performed to measure fluorouracil concentration in the peritoneal fluid, plasma, liver, kidney and heart tissue at 24 hour, 72 hour and 168 hour after insertion of Fu-PGA disk(s). Myelosuppressive action of this composite also was determined following its administration. The data of this study suggested that Fu-PGA composite will be a new device releasing drugs in a controlled manner and having targetability to peritoneum, and this device will be improving the efficacy of intraperitoneal chemotherapy for gastric adenocarcinoma.

수술 전 고빌리루빈혈증 환자에서 췌십이지장 절제술의 안정성

김태윤,김성용,백무준,이문수,조무식,김창호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Backgrounds: Pancreaticoduodenectomy is accompanied by a considerable risk of postoperative complication and potential death. Pancreaticoduodenectomy in patient with obstructive jaundice carry on increased risk of postoperative complication. Preoperative biliary drainage has been developed to reduce this morbidity and mortality but the benefit of preoperative biliary drainage is still questioned for several reasons. This study evaluated postoperative outcomes following pancreaticoduodenectomy in relation to patients with hyperbilirubinemia. Methods: Ninety two patients who underwent pancreaticoduodenectomy between 1992 and 2001 were divided into two groups. Group A included 11 cases in patient with preoperative hyperbilirubinemia (serum bilirubin > 10 mg/dl), and the other 81 cases (serum bilirubin < 10 mg/dl) were Group B. In group A, 6 patients underwent preoperative biliary drainage. In group B, 31 patients underwent preoperative biliary drainage. Postoperative morbidity and mortality were anlaysed comparing with two groups by chi-squared test retrospectively. Results: In group A, whose average value of serum bilirubin was 15.2 mg/dl (range 10.2-20.3 mg/dl), wound complications were seen in 9.0%, hemorrhage in 18.1%, delayed gastric empting in 18.1%, anastomosis leakage in 18.1%, abscess in absent, and mortality in 9%. In group B, whose average value of serum bilirubin was 2.3 mg/dl (range 0.8-7.3 mg/dl), wound complications were seen in 14.8%, hemorrhage in 8.6%, delayed gastric empting in 9.8%, anastomosis leakage in 22.1%, abscess in 4.9%, and mortality in 4.9%. There was no significant difference in morbidity and mortality between two groups. Conclusion: Preoperative hyperbilirubinemia did not influence the incidence of postoperative outcomes following pancreaticoduodenectomy. It can be performed safely in patient with hyperbilirubinemia.

간절제술 후 발생한 기관지 담도 누공 2예

김태윤,김성용,백무준,이문수,조무식,김창호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A bronchobiliary fistula (BBF), which is defined by an abnormal communication between the biliary system and the bronchial tree, is an uncommon complication after hepatic resection, trauma, hydatid disease, choledocholithiasis and other causes of biliary obstruction. Bronchobiliary fistulae are rare complications of hepatic resection that can present from days to years after operation. Endoscopic retrograde cholangiopancreatography and PTC are the diagnostic studies of choice and offer the possibility of therapeutic intervention. We report the cases of a 56-year-old woman with cholangiocarcinoma, who developed a BBF 7 months after right hepatic lobectomy and 64-year-old man with intrahepatic duct stones who underwent hepatic resection.

콘크리트의 급속염화물침투시험에 의한 염화물이온 확산계수 평가에 관한 실험적 연구

김갑수,조봉석,장종호,김재환,김용로,김무한 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1(구조계)

Chloride ions are considered to be the major cause of steel corrosion in concrete structures exposed to seashore environments and also permeation of chloride is controlled by chloride diffusion. Therefore, the study on chloride diffusion of concrete have been done so far by many researchers. In this study, several factors such as capacity of voltage, time of an electric current, concentration of NaCl solution, water-cement ratio, and temperature of the solution were examined to grasp what influence they were on the chloride ion diffusion properties using the Rapid Chloride Penetration Test(RCPT) by electrophoresis. Also standing on the basis of the such result application possibility of Rapid Chloride Penetration Test(RCPT) used in this study will be evaluated and the basic data on the durability design for the chloride attack will be suggested.

Mirizzi 증후군의 변형된 분류와 치료

김형철,강길호,채만규,김성용,백무준,이문수,박상흠,이문호,김창호,송옥평,조무식,박희주 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Purpose : The Mirizzi syndrome is relatively rare and preoperative diagnosis of this disease is difficult. In 1978, Morelli suggested the subclassification of the Mirizzi syndrome into acute or chronic form. We experienced 5 cases of acute form. We analysed clinical features, preoperative radiologic findings and operative findings of 18 cases including acute forms which were diagnosed as Mirizzi syndrome and should suggest the modified classification of Mirizzi syndrome for choice of appropriate treatment. Method : From January 1995 to December 1998, 18 cases, of which 8 cases were diagnosed at Soonchunhyang University Chunan Hospital, and 10 cases were reported in the Korean Journal were retrospectively analysed with regard to clinical features, preoperative radiologic findings and operative findings. According to the clinical features, whole cases were divided into type Ⅰ(acute form) and type Ⅱ(chronic form) and then each type of cases were subclassified according to preoperative radiologic findings and operative findings. Results : Of 18 cases there were 5 cases in type Ⅰ(27.8%), 13 cases in type Ⅱ(72.2%). Type Ⅱb was most common. Type Ⅰa cases were treated only with cholecystectomy. We applied cholecystectomy, T-tube choledochostomy and patch technique in type Ⅰb and thpe Ⅰc cases. Cholectystectomies including removal of gallstones and internal drainage procedures were done in type Ⅱ chronic forms. Conclusion : The acute form(Type Ⅰ) of Mirizzi syndrome was suggested by Morelli might be subclassified into typeⅠa,Ⅰb and Ⅰc following the presence of the necrotic defect in common hepatic duct. Through the modified classification of Mirizzi syndrome based on clinical feature, preoperative radiologic findings and operative findings, we can choice appropriate treatment.

간세포암에서 중앙 2구역 절제술의 유용성

김태윤,김성용,백무준,이문수,조무식,김창호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Liver resection for hepatocellular carcinoma(HCC) is now popular. For treatment of centrally located hepatocellular carcinoma, central bisegmentectomy is recommended as a radical surgical procedure and may have an important advantage. Five patients with HCC underwent central bisegmentectomy with an operating time of 380-420 minutes. One patient who had undergone preoperative live artery embolization died by car accident. Four patients survived without relapse 13-35 months postoperatively. Central bisegmentectomy is a safe and effective operative procedure for the treatment of centrally located HCC.

노치 형상 및 냉각속도에 따른 Zr-2.5Nb 압력관의 DHC거동

김상재,김영석,임경수,김성수,정용무 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.1

The objective of this study is to investigate the delayed hydride cracking (DHC) velocity and the incubation time for the water-quenched and furnace-cooled Zr-2.5Nb tube with the different radius of a notch tip. DHC tests were carried out at constant K_1 of 20 MPa√m and 250℃ on the cantilever beam (CB) specimens subjected to furnace cooling or water quenching after electrolytic charging with 57 or 72 ppm hydrogen, respectively. An acoustic emission sensor was attached to the CB specimens to detect the incubation time before the start of DHC. The shape of the notch tip changed from the fatigue crack to the dull crack with its radius ranging from 0.1 to 0.15 mm. The DHC incubation time increased remarkably with the increasing radius of the notch tip, which appeared more strikingly on the furnace-cooled CB specimens than on the water-quenched ones. However, both furnace-cooled and water-quenched CB specimens indicated little change in the DHC velocity with the radius of the notch tip unless their notch tip exceeded 0.125mm. These results demonstrate that the uncleation rate of hydrides at the notch tip determines the incubation time and the DHC velocity becomes constant after the concentration of hydrogen at the notch tip reaches the terminal solid solubility for dissolution (TSSD). This observation agrees well with Kim's DHC model. A difference in the incubation time and the DHC velocity between the furnace-cooled and water-quenched specimens is discussed in terms of the uncleation rate of hydrides at the notch tip and the hysteresis of hydrogen solubility.

췌십이지장절제술 후 발생한 담즙누출의 치료

김태윤,김성용,백무준,이문수,조무식,김창호 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Operative morbidity and mortality of pancreaticoduodenectomy has been decreasing but remains high. Unintended postoperative cutaneous biliary fistula involving the major bile ducts is an uncommon complication of pancreaticoduodenectomy. Prolonged biliary drainage may lead to severe metabolic disturbances, renal failure and cardiovascular collapse, and usually requires operative reintervention. Among 90 patients who underwent pancreaticoduodenectomy from Feb. 1992 to Dec, 2000, 70 patients whose hospital records could be reviewed were included in this study. Cutaneous biliary fistula were observed in 19 cases(27.1%). In the 14 cases, a biliary drain was inserted around the injured duct via the biliocutaneous fistula. In these cases, biliary drainage alone resulted in resolution of the bile leak, because the injury was partial without a stricture. In the 5 cases, biliary stents were placed percutaneously across the injured portion of the bile duct. Pancreaticoduodenectomy is still associated with high mortality and morbidity even though there has been significant progress in the field of pancreatic surgery and postoperative follow-up. In the absence of organic stenosis, percutaneous drainage approach may be useful in patients with postoperative biliocutaneous fistula.