위장관 간질종양의 임상 및 병리학적 고찰

김영호,장우영,이순진,손희정,최규완,도재혁,백승운,이준행,이풍렬,이종철,박철근,임윤정,김갑철,김재준,임효근 대한소화기학회 2001 대한소화기학회지 Vol.37 No.3

Background & Aims: Gastrointestinal stromal tumor (GIST) constitutes primary nonepithelial neoplasms of the gastrointestinal tract and includes most tumors previously designated as leiomyomas/leiomyosarcomas. GIST is pathologically divided into benign, borderline and malignanct tumor. This study was carried out to delineate the clinical and pathologic features of GIST and to establish the features predicting malignancy. Methods: Clinicopathologic data of 84 patients who had GIST from 1995 to 1999 were reviewed. Results: The subjects were 42 men and 42 women, and their mean age was 59.3±13.2 years. We located fifty-two tumors in the stomach, 28 tumors in the small intestine and 4 tumors in the colorectum years. Histopathology revealed benign tumors in 23 of the 84 patients, borderline tumors in 22, malignant tumors in 39. The average size of tumors was 6.23 cm in diameter (range, 0.6-26 cm). Metastasis was noted in 15.5% of the patients at diagnosis. On endoscopy, ulceration was more common in malignancy. Endsonographic findings except size were not significant statistically. On contrast enhanced computed tomography, malignancy showed more irregular shape and variable attenuation than benign lesions, which seemed to be valuable factor. Conclusions: The variables predicting malignancy were large tumor size (≥5 cm), location of the colorectum, palpable abdominal mass, ulceration on endoscopy, and less uniformity in shape and variable attenuation on computed tomography.

니세틸 정(아세틸 - 엘 - 카르니틴 500mg)에 대한 뉴로세틸 정의 생물학적 동등성

조혜영,오인준,이용복,임동구,문재동,심영순,김은아,정현철 한국약제학회 2001 Journal of Pharmaceutical Investigation Vol.31 No.1

Acetyl-L-carnitine (ALC), an endogenous component of the L-carnitine family, is naturally occurring molecule synthesized from L-carnitine (LC) by carnitine acetyl transferase. ALC has been shown to improve the cognitive performance of patients suffering from dementia of the Alzheimer's type and proposed for treating Alzheimer's disease in pharmacological doses. The purpose of the present study was to evaluate the bioequivalence of two ALC tablets, Nicetile^(TM) (Dong-A pharmaceutical Co., Ltd.) and Neurocetil^(TM) (Kyung-Dong Pharmaceutical Co., Ltd.), according to the guidelines of Korea Food and Drug Administration. Twenty six normal male volunteers, 22.80±2.76 year in age and 63.07±7.98 ㎏ in body weight, were divided into two groups and a randomized 2 × 2 cross-over study was employed. After one tablet containing 500 ㎎ of ALC was orally administered, blood was taken at predetermined time intervals and the concentrations of ALC in serum were determined using HPLC with fluorescence detector. Because of the presence of endogenous ALC, the calibration was performed using dialyzed serum. Pharmacokinetic parameters such as AUC_t, C_(max) and T_(max) were calculated and ANOVA was utilized for the statistical analysis of the parameters. The results showed that the differences in AUC_t, C_(max) and T_(max) between two tablets were 2.72%, -0.65% and -8.42%, respectively, when calculated against the Nicetile^(TM) tablet. The powers (1-β) for AUC_t and C_(max) were 94.87% and 87.17%, respectively. Minimum detectable differences (△) at α=0.05 and 1-β=0.8 were less than 20% (e.g., 15.58% and 19.16% AUC_t and C_(max), respectively). The 90% confidence intervals were within ±20% (e.g., -11.84∼6.41 and -10.57∼11.88 for AUC_t and C_(max), respectively). Two parameters met the criteria of KFDA for bioequivalence, indicating that Neurocetil^(TM) tablet is bioequivalent to Nicetile^(TM) tablet.

UO2 소결체에 고온연소반응을 이용한 SiC 코팅

김봉구,최용,김정원,이영우,손동성,김길무 대한금속재료학회(대한금속학회) 2000 대한금속·재료학회지 Vol.38 No.5

Multi-layer coating of silicon carbide and graphite on UO₂ nuclear pellet was carried out with a fluidized bed type chemical vapor deposition unit to enhance the inherent safety of the nuclear pellet and to develop a renovative coating process. Silane, propane and argon gases were used as the source and carrier gases to deposit silicon and pyrolytic carbon. Combustion reaction was performed in an inert argon atmosphere, which conditions were pre-determined by numerical evaluation of the combustion reaction between silicon and carbon to synthesize silicon carbide. Microstructural observation of the combustion products by scanning electron microscopy showed that the inner and outer pyrolytic carbon layers were equiaxed structure. Chemical analysis by Auger electron spectroscopy and X-ray diffractometry revealed that the middle layer formed by a combustion reaction was fine crystalline beta-silicon carbide.

말기 신부전증을 동반한 전신성 홍반성 낭창 환자에서 동종 신장이식 증례

김호연,박준철,민병석,김진숙,방병기,이영석,고용복,이용각,김용일 대한신장학회 1983 Kidney Research and Clinical Practice Vol.2 No.2

In systemic lupus erythematosus renal involvement is very common and it accounts for the leading cause of death of the disease. Since SLE is a systemic disease involving many organs and it is caused by altered immunological background many physicians tend to hesitate in employing hemodialysis and renal transplantation. We report the first renal transplantion in Korea which was performed in a patient with end-stage renal failure due to SLE. The patient had positive LE pre- parations, low serum complement, antibody to native DNA and renal biopsy showing diffuse proliferative lupus nephritis but she manifested decreasing clinical activity during hemodialysis. The patient received kidney allograft from living related donor after unilateral nephrectomy. There was no clinical or his- tological evidence of rejection or recurrence of lupus nephritis in the grafted kidney. The patient maintains normal renal function 18 months after renal trans- plantation.

하기도 감염증 환자의 치료에 있어서 Ceftibuten과 Cefaclor의 유효성 및 안전성 비교평가를 위한 임상시험

이홍렬,김세규,장준,김성규,이원영 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2

Ceftibuten은 β-acyl side chain에 carboxye-thylidine moiety를 가진 aminothiazolyl cephalosporin으로, 전형적인 plasmid β-lactamase 및 새로운 TEM 효소에 대하여 구조적이 안정성과 경구 복용시의 흡수 정도가 향상되었다. 다른 3 세대 경구용 cephalosporin과 마찬가지로 항균력이 비경구용 cephalosporin와 비슷하고 약력학적으로는 더 우수하기 때문에 외래 환자들의 하부 호흡기계 감염에 비경구용 약제의 차선책으로 사용이 가능하다. 본 연구에서 병원외에서 발생한 하부 호흡기계 감염을 대상으로 ecftibuten과 cefaclor를 투여한 결과 임상 양상은 모두 치료후에 호전되었다. 임상적으로 유효한 cure와 improvement의 예는 ceftibuten군에서 89.7%, cefaclor군은 87.5%씩 이었고 양군간에 유의한 차이는 없었다. 세균학적으로 ceftibuten 군에서 elimination이 더 많았으나 역시 양군간에 유의한 차이는 없었다. Ceftibuten군중 3.0%, cefaclor군은 7.4%에서 부작용이 관찰되었다. 이상의 결과로써 ceftibuten은 병원외에서 발생한 하부 호흡기계 감염에 대하여 외래에서 효과적으로 사용할 수 있는 항생제라고 생각된다. Ceftibuten is the aminothiazolyl cephalosporin, which contains a carboxyethylidine moiety at position 7 of the β-acyl side chain. The provides β-lactamase stability against both the classic plasmid β-lactamases, and also the new TEM enzymes, and excellent absorption by the oral route. Because, similarly to other oral third-generation cephalosporins, ceftibuten has the expanded antimicrobial spectrum like parenteral third-generation cephalosporins and better pharmacokinetic properties, it may be a good alternative against lower respiratory tract infection, mainly in the outpatient setting. In this study, we examined the efficacy and safety of ceftibuten in the patients with the community-acquired lower respiratory tract infection. We administrated ceftibuten or cefaclor in randomized comparative manner. Clinical manifestations were improved in both groups and overall effective rates were 89.7% in ceftibuten group and 87.5% in ceftclor group with no significant difference. Most isolated pathogens were eliminated by ceftibution such as Haemophilus influenzae, Streptococcus pneumoniae and so on, even though cases were not sufficient. There was no serious adverse effect by ceftibuten. Conclusively, ceftibuten was thought to be an effective oral antobiotic against community-acquired lower respiratory tract infection in the outpatient setting.

Penstemon penlandii 의 발아촉진방법

이석영,최원열,백형진,윤문섭,줄리라프만 한국국제농업개발학회 1999 韓國國際農業開發學會誌 Vol.11 No.2

Penstemon penlandii는 미국의 록키산맥에서 소집단으로 발견되나 자연상태에서는 발아가 불량하여 멸종위기에 처해있어 이 식물의 보존을 위한 발아방법을 구명하기 위하여 본 시험을 수행한 결과는 다음과 같다. 1. P. penlandii종자는 thermogradient에서 발아시킨 결과 10-30, 15-25, 20-30, 25, 25-30 그리고 15-30℃ 등의 변온조건에서 발아가 증진되었으며 높은 온도 조건에서는 미생물 오염에 의해 발아 및 유묘생장이 장해를 받았다. 2. 30psi에서 10-20초 동안 종피에 자극을 주었을 때 발아율 및 발아속도지수가 높았으나 일부 종자는 휴면타파가 이루어지지 않았다. 3. 종피에 물리적자극을 준 종자를 1mM의 GA3에 24시간 동안 침지하면서 15ccs-1속도로 aeration 시킨 후 blotter에 치상하였을 때 발아가 가장 촉진되었다. This study was undertaken to determine the germination requirements of Penstemon penlandii. The highest germination occurred using the scarified seeds (either hand or mechanical) on the thermogradient plate at 10-30, 15-25, 20-30, 25, 25-30 and 15-30℃. Individual germinators were used to verify thermogradient plate results, and speed of germination analysis suggested that 15-30℃ was the optimum temperature for rapid germination of P. penlandii after mechanical scarification. Laboratory germinations at 15-30℃ of mechanically scarified seeds (20-30 psi and 10-80 seconds) were correlated with seedling emergence in the greenhouse. Scarification rates of 30psi for 10-20 seconds produced highest rates of germination and emergence in laboratory and greenhouse tests. The germination procedure of submerging seeds in aerated 1mM GA3 for 24hours, placing seed on water moistened blotters at 15-25℃, and hand scarifying ungerminated seeds after 14days and allowing them to germinate for an additional week gave comparable germination percentage to hand scarification, mechanical scarification, and tetrazolium viability. Based on these data the recommended germination method for this species would be to submerge seeds in aerated (15ccs-1)1mM GA3 for 24h, place seeds on water moistened blotters, make the first counts at 14d and hand scarify the remaining dormant seed with final counts at 21d, or scarify seed by hand or with a mechanical scarifier before germination on blotters moistened with 1mM GA3, and counted after 7, 14, and 21 days.

역류성 식도염 환자에서 Helicobacter pylori 치료 1 년 후 증상과 내시경적 변화

김영호,손희정,최규완,박동일,백승운,이준행,고광철,이풍렬,이종철,임윤정,김재준 대한소화기내시경학회 2001 Clinical Endoscopy Vol.24 No.1

Glutaraldehyde 와 자동 세척기를 이용한 내시경 소독방법의 임상에서의 유용성

김영호,손희정,윤성원,최규완,이남용,백승운,이준행,고광철,이풍렬,이종철,송재훈,안병훈,김재준,최원혁,홍일철 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6

Background/Aims: Safety of endoscopic procedures has been a major issue over the last 10 years. Most endoscopy units use 2% glutaraldehyde and automated endoscope reprocessors (AERs) for disinfecting gastrointestinal endoscopes. We attempted an in-use evaluation of the current reprocessing procedures. Methods: Thirty flexible endoscopes were randomly collected just after upper endoscopic examinations and were disinfected using 2% glutaraldehyde in an AER. Cultures were taken from biopsy channels (S-l), tip of the insertion tubes (S-2), umbilical cords (S-3), and angulation knobs (S-4). Results: In 63,3% (19/30) of endoscopes, there was no microbial contamination after disinfection procedures. The culture positive rates of S-l, S-2, S-3, and S-4 samples were 20,0%, 0.0%, 3.3%, and 20.0%, respectively. Microorganisms of 13 species were identified, but there was no pathogen related with reported infectious complications after endoscopic procedures. Conclusions: Current disinfection procedure using 2% glutaraldehyde and an AER appears to be very effective in decontaminating patient-used endoscopes. Low level microbial contamination of endoscopes after conventional reprocessing methods may not impose great risk on patients.

Dieulafoy 양 병변에 의한 십이지장게실 출혈 1 예

김상현,김경환,이동현,송철수,정노원,박상제,김은규,하홍성,나일환,황윤이,성은영,최익수,신영기 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.1

Duodenal diverticula are first reported by Chomel in 1710. Duodenal diverticula are relatively common in adults with a prevalence of 23% in SRCP. The most duodenal diverticulum is asymptomatic. Complications such as obstruction, cholangitis, blliary stones, ulceration, perforation and hemorrhage can occur in approximately 10%. However, relatively few cases of bleeding from a duodenal diverticulum have been reported. The cause of bleeding from a duodenal diverticulum is uncertain and various suspected etiologies were suggested, such as ectopic gastric mucosa, stasis-induced ulceration, erosion into major vessels, aortoenteric fistuias, intradiverticujar polyp, aspirin-induced erosion. We report a case of a bleeding duodenal diverticulum by a Dieulafoy-like lesion and suggest this 1esion as one of posslble causes of blee4ng in duodenal diverticulum.

대장 선종과 Apolipoprotein E 유전형과의 관계

김영호,최윤호,손희정,강태욱,최규완,최봉준,이종철,박상종,이지민,배문희,김재준,이풍렬 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.1

Background/Aims: Apolipoprotein B polymorphism plays an important role in the metabolism of cholesterol. And bile acids, which may be related to the development of colorectal adenomas, An association between apolipoprotein B genotype and colonic adenomas bas been reparted in a western country. This study was designed to determine whether the apolipopratein S was genotype would be associated with proximal or distal colonic adenomas in Koreans. Methods: On the colonoscopy, colonic adenomas were found in 132 patients. Proxima1 colonic adenoma was found in 35 patients and distal colonic adenoma was found in 97 patients. Serum leveis of total cholesterol, LDL-cholesterol, HDL-cholesterol and trlglyceride were measured. Apolipoprotein E genotype was determined by PCR and allele specific oligonucleotide hybridization. 279 contro1 subjects without an adenoma on the screening sigmoidoscopy were se1ecfed randomly. Results: The serum levels of total choles0'rol, LDL-cholesterol, HDL-cholesterol and triglyceride did not significantiy differ between each adenoma group and control group. The individual frequencies of ε2, ε3 and ε4 alleles in patients with colonic adenomas did not differ from those in control subjects. The frequency of either heterozygote or homozygote for g 4 allele in patients with proximal adenoma was lower than that in control subjects (0.029 vs O.I68, p $lt; 0.05). Conclnsions: The data suggest that g 4 allele may be associated with a lower risk for the development of proximal colonic adenoma in Korean men.