Shope Rabbit Papilloma Virus에 의한 종양발생에 관한 연구

任春彬,梁容泰 중앙대학교 의과대학 의과학연구소 1975 中央醫大誌 Vol.1 No.1

A study was made with Shope rabbit papilloma virus(RPV) on 1) papilloma induction and cancerous transformation in adult rabbits and 2) the progress of Shope papillomas induced in newborn rabbits, in order to confirm and extend the oncogenicity of RPV in adult rabbits and to observe the applicability of newborn rabbits for tumor induction by RPV. Virus inoculum was prepared from cottontail rabbits papilloma tissues stored in buffered glycerin (cottontail Shope T-730,1968.5.6.). Inoculation of RPV was made either by multiple puncture method into adult's rabbit skin or by intradermal injection into newborn rabbit's skin. Following RPV inoculation observations were made on the development of papilloma, cancerous transformation and spontaneous regression of induced papillomas. The results are summarized as follows: 1. Typical papillomas developed in adult rabbits at the site of RPV inoculation(10^-1,10^-2, and 10^-3) with a latent period of 2 to 5 weeks, and this confirmed a well-known stability of RPV during such a long period of storage in 50% buffered glycerin. 2. of 5 adult rabbits in which papillomas developed after RPV inoculation, cancerous transformation was observed in 2 rabbits approximately 1 year after virus inoculation at the sites where high concentration of RPV was inoculated. 3. RPV inoculation (10^-1) into newborn rabbit's skin also resulted in the development of papillomas at the site of virus inoculation. The result of papilloma induction in newborn rabbits indicated that the latent periods were at least 1 to 2 weeks shorter and rather homogeneous than those in the adult rabbits, and that the papillomas appeared to persist longer than in adult rabbits.

광범위한 미만성 지방종증 환자의 전신마취

안은진;강현;김태화;신화용;김한구;차성재;김진윤 중앙대학교 의과대학 의과학연구소 2012 中央醫大誌 Vol.37 No.1/2

Morbid obesity effects airway management and pulmonary mechanics. Eight- year-old male child with normal development was presented with extensive diffuse lipomatosis on his abdomen and trunk. He underwent an abdominoplastic surgery to remove abdominal wall mass. After the surgery, total 7270 g mass was removed. During the operation, we studied the change of pulmonary mechanics by measuring airway pressure, compliance and airway resistance by spirometer. The compliance was significantly decreased when the patient’s position was changed to Trendelenburg and increased when the mass was removed. Airway pressure revealed reverse to compliance. Airway resistance showed no significant change. The operation took 9 hours and 50 minutes and the anesthesia went through uneventfully.

Angiographic Resolution of Coronary Aneurysm Developed after Implantation of Sirolimus-eluting Coronary Stent : Discrepancy between Intravascular Ultrasound and Coronary Angiographic Findings

Choi, Yong-Woo;Kim, Sun-Mi;Jin, Xiong-Jie;Kwak, Ji-Yeong;Jung, Ju-Yang;Mun, Jun-II;Lim, Hong-Seok 중앙대학교 의과대학 의과학연구소 2012 中央醫大誌 Vol.37 No.1/2

The use of drug eluting stent (DES) has been increased in recent years because of its ability to inhibit neointimal proliferation. However, it may affect the normal healing process of the vessel wall after vascular injury and may be associated with coronary artery aneurysm formation in rare cases. We report a case of angiographic spontaneous resolution of coronary aneurysm developed after implantation of sirolimus-eluting coronary stent at the left anterior descending artery, diagonal branch, and left circumflex artery. But, there was discrepancy between intravascular ultrasound (IVUS) and coronary angiographic findings. IVUS demonstrated no significant shrinkage of maximal external elastic membrane (EEM) compared to earlier examination but echogenic tissue was filled in the free space between the stent and EEM at the stented segments where the angiographic resolution of the aneurysm occurred. We found out that an angiographic resolution of coronary aneurysm does not always guarantee real shrinkage of vessel wall, and fill-up of aneurismal space with thrombus or tissue could be an important mechanism of spontaneous resolution of DES related coronary aneurysm. Optimal treatment could be decided based on longer-term follow-up of patients which provide more accurate characterization of the consequences of DES-related aneurysm.

유지 혈액투석 환자의 계절에 따른 생화학적 지표의 변화 양상

김동휘;김재승;김대정;송영주;이창수;박상원;김경욱 중앙대학교 의과대학 의과학연구소 2012 中央醫大誌 Vol.37 No.1/2

Background/Aims: In patients with ESRD who are undergoing hemodialysis, the various clinical and laboratory values are known to be changed by season, although they vary by study. This study aimed to investigate the relationship between the seasonal variations and each biochemical parameters in hemodialysis. Methods: From December 2007 to November 2010,22 patients with ESRD were included in this study. Clinical and laboratory test was performed monthly. The results were analyzed every three months. Then correlation between seasonal variations and relevant factors was analyzed. Results: Seasonal variations were observed in systolic and diastolic blood pressure, total protein, albumin, glucose, creatinine, total CO2 and potassium. Interdialytic variations in hemoglobin, total protein, alb니min,glucose, and potassium and increased body weight were found to have significant influence on the sodium. In both diabetic and non-diabetic groups, significant variations were observed only in sodium and glucose. In heart fail니re and normal groups, no significant variation was observed. Conclusions: Clinical and laboratory values in patients undergoing hemodialysis has seasonal variations. Awareness of these variations will allow seasonal adjustment of nutrition education for hemodialysis patients, prediction of changes in electrolytes and relevant factors, and improvement of the quality of life and clinical prognosis.

대장내시경을 시행한 결합조직형성 소원형세포종양 1예

이제수 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4

저자들은 단순 복부 불쾌감 및 우하복부에서 종괴가 만져지는 듯한 양상을 보인 남자 환자에서 검사를 진행하는 과정에서 상피세포 표지자인 pancytokeratin과 신경원성 표지자인 neuron specific enolase, 간엽조직 표지자 desmin과 vimentin에서 모두 양성을 보이는 비전형적 양상과 함께, 내시경상 검사상 외벽으로부터 눌리는 듯한 모습을 보이지만, 정상 점막을 보이는 결합조직형성 소원형 세포종양을 확진한 증례를 경험하였기에 문헌 고찰과 함께 보고 하는 바이다. Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive neoplasm that involves the abdominal and pelvic cavities in relatively young man. We experienced a 31-year-old man with right lower quadrant discomfort for 1 month. Normal mucosa with external compressing mass was found in colonoscopy and liver metastasis occurred with peritoneal carcinomatosis in CT evaluation. Histological finding showed nests of undifferentiated tumor cells were surrounded by fibrous stroma. The tumor cells had small hyperchromatic nuclei with inconspicuous nucleoli. Immunohistochemical staining for vimentin, pancytokeratin, NSE, desmin were all positive. We report here on a case of atypical DSRCT with immunohistochemistic and endoscopic finding arising from intra-abdominal cavity.

전신홍반루푸스 환자에서 Corticosteroids 복용 중에 B형 간염이 활성화한 1예

곽지영 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4

Hepatitis B virus (HBV) infection is endemic in Asia and reactivation of HBV is a well recognized complication in infected patients who undergo cytotoxic chemotherapy for cancer and immunosuppressive therapy. Since immunosuppressant can facilitate viral replication and lead to reactivation of HBV, the management of systemic lupus erythematosus (SLE) patients who are HBsAg-positive presents a clinical challenge. We report here on a 29-year old female with SLE and HBsAg positivity who presented hepatitic flare during corticosteroid treatment only. HBsAg carriers who receive cytotoxic or immunosuppressive therapy are at considerable risk of reactivation of HBV infection. Antiviral prophylaxis is clinically efficacious as primary prophylaxis to prevent HBV reactivation. Risk factors allowing patient stratification for HBV reactivation include foremost the HBV DNA level before initiation of immunosuppresive treatment, including corticosteroids. Monitoring for development of acute flare of HBV should be performed by serial measurement of HBV DNA and liver enzymes regularly.

자가면역 질환을 동반한 당뇨병성 근육경색 1예

반가영 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4

Diabetic muscle infarction (DMI) is a rare complication that usually occurs in patients with longstanding microvascular complications of diabetes. The typical clinical presentation of DMI includes a sudden onset of pain, tenderness, and swelling of the lower limbs. DMI can be diagnosed by typical clinical manifestations and magnetic resonance imaging (MRI). Treatment usually includes immobilization of the affected extremity and taking analgesics. A 44 year-old woman with type 2 diabetes mellitus and Hashimoto's thyroiditis for 10 years, presented with an abrupt and spontaneous onset of severe pain in the left thigh. In order to evaluate the etiology, angio-computed tomography, bone scan, and MRI of the lower extremities were performed. DMI was diagnosed based on the hyper-intense T2 weighted signals on the MRI. The patient was fully recovered with the conservative treatment.

Outcomes of Free-Tension Transobturator Tape (TOT) Surgery under Local Anesthesia versus General Anesthesia for Female Stress Incontinent Treatment

응웬하이박 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4

We evaluate our experience with Transobturator Tape (TOT) surgery under local and general anesthesia for treating female stress incontinence. Totally 31 women with genuine urinary incontinent were selected in this study. They were scheduled for TOT surgery under local anesthesia or general anesthesia. The study protocol involved recording of preoperative and perioperative details and postoperative evaluation. Fifteen patients were included in local group and sixteen remainders in the general group. 100% of stress urinary incontinent symptom was cured. The cure rate of urge symptom was 80% vs. 50% for local group vs. general group, respectively, at both short-term and long-term follow-up. There was no significant difference in mean operating room and surgical time. But a statistically significant difference in mean of recovery room time, hospital stays and hospital cost was recorded (p <0.005). We concluded that TOT insertion is a best indication for correcting urinary stress incontinence in women. It can be performed effectively under both local and general anesthesia. Local anesthesia with sedation has advantage only in regarding to recovery time and total hospital cost, but much disadvantage in term of early and late postoperative complications.

출혈성 용종과 동반되어 발생한 비외상성 혈액담즙증 1예

이승훈 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.3/4

Hemobilia is a status of hemorrhage into the biliary tract, and is a rare cause of gastrointestinal bleeding. Although most common causes of hemobilia are traumatic or iatrogenic, nontraumatic hemobilia is reported rarely. Diagnosis of hemobilia is composed of upper gastrointestinal endoscopy, abdominal ultrasonography, abdominal computer tomography and angiography. However in case of anatomical variation, diagnosis could be delayed. We present a case of hemobilia accompanied hemorrhagic polyp, which was diagnosed late.

말기콩팥질환자에서 대장정결을 위한 소량의 인산나트륨 투여 후 발생한 중증 고인산혈증과 저칼슘혈증 1예

박지훈 외 중앙대학교 의과대학 의과학연구소 2011 中央醫大誌 Vol.36 No.1/2

Oral sodium phosphate is currently used for colon preparation prior to colonoscopy or barium enema. Sodium phosphate induces life threatening electrolyte abnormalities in patients with renal insufficiency. We report a case of severe hyperphosphatemia and secondary hypocalcemia due to administration of an oral sodium phosphate-containing bowel preparation (small amounts) in patients with end stage renal disease. A 75-year-old woman with chronic kidney failure without dialysis, was evaluated for a high serum CEA levels. The patient had ingested a 15 mL doses of sodium phosphate solution the previous night, in preparation for a screening colonoscopy. Her serum phosophorus and calcium levels were normal before bowel preparation. Five hours after ingestion of sodium phosphate solution, the patient complained muscle cramping, distal extremity numbness, and tingling sensations. Laboratory evaluation revealed severe hyperphosphatemia and secondary hypocalcemia. Repeated intravenous administration of calcium and insulin, and oral administration of phosphate binding resin did not improve her clinical symptoms and electrolyte abnormalities. These abnormal manifestatioins resolved rapidly after hemodialysis. The patient subsequently underwent colonoscopy without any complications and was diagnosed with cecal cancer.