초기 자궁내막암 환자에서의 복강경유도하 질식 자궁절제술과 복식 자궁절제술에 대한 비교 연구

김민규 ( Min Kyu Kim ),최동석 ( Dong Seok Choi ),김우영 ( Woo Young Kim ),최철훈 ( Chel Hun Choi ),김태중 ( Tae Joong Kim ),이정원 ( Jeong Won Lee ),김병기 ( Byoung Gie Kim ),이제호 ( Je Ho Lee ),배덕수 ( Duk Soo Bae ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12

목적: 초기 자궁내막암의 수술적치료 시 복강경유도하 질식 자궁절제술 및 골반림프절절제술군과 복식수술군의 수술결과 및 재발율에 대해 비교하고자하였다. 연구 방법: 2003년 3월부터 2005년 5월까지 초기 자궁내막암 환자를 인구학적 특성이 같은 63명을 선택하여 복강경유도하 질식 자궁절제술 및 골반림프절절제술군 26명, 복식수술군 37명으로 나누어 수술 전후 혈색소 차이, 평균수술시간, 취득한 골반림프절갯수, 평균재원일수, 추가치료율, 재발률을 비교하였다. 결과: 복강경유도하 질식 자궁절제술 및 골반림프절절제술을 시행한 군과 복식수술을 시행한 군과의 비교에서 수술 전후 혈색소 차이, 평균수술시간, 취득한 골반림프절 갯수, 평균재원일수, 재발률에 통계적으로 유의한 차이가 없었다. 결론: 초기 자궁내막암의 수술 시 복강경유도하 질식자궁절제술 및 골반림프절절제술 방법이 복식방법에 비해 수술결과 및 재발률에 통계적으로 유의한 차이가 없으며 그 대체 수술법으로 많은 활용이 기대되었다. Objective: To compare laparoscopic surgery with conventional abdominal surgery in patients with early stage endometrial cancer. Methods: A retrospective review of 63 patients with early stage endometrial cancer managed between March 2003 and May 2005. Two groups were defined whether they had been treated by laparoscopy (case group: n=26) or by laparotomy (control group: n=37). We compared age, body mass index (BMI), hemoglobin change, operation time, number of pelvic lymph nodes, hospital stay, case with adjuvant treatment and recurrence between two groups. Results: There was no statistical difference in characteristics (age, BMI, nulliparity, previous abdominal surgery, FIGO stage, histologic grade). between case and control group. In addition, there was no statistical difference in operation data and outcomes between two groups. Hemoglobin changes were 1.1 g/dL (case group) vs 1.7 g/dL (control group) (p=0.072). Operation time was 131 min vs. 115 min. The numbers of lymph nodes obtained were 8.7 vs 7.7 (right) 9.2 vs. 7.6 (left). Hospital stays were 8.4 vs. 9.2 days. Adjuvant treatment cases were 7 vs. 15. Recurrent case was one in each group. Two patients initially evaluated by laparoscopy were converted to laparotomy due to bleeding and adhesion. Conclusion: Laparoscopic surgery for treatment of early endometrial cancer is a safe and effective alternative to laparotomy . However, long-term survival and risk of recurrence have yet to be determined.

Purification and Characterization of Helicobacter pylori ${\gamma}$-Glutamyltranspeptidase

Song, Jae-Young,Choi, Yeo-Jeong,Kim, Jeong-Min,Kim, Yoo-Ree,Jo, Jin-Seong,Park, Jin-Sik,Park, Hee-Jin,Song, Yun-Gyu,Lee, Kon-Ho,Kang, Hyung-Lyun,Baik, Seung-Chul,Youn, Hee-Shang,Cho, Myung-Je,Rhee, Kw The Korean Society for Microbiology 2011 Journal of Bacteriology and Virology Vol.41 No.4

Gamma-glutamyltranspeptidase (GGT) was purified to electrophoretic homogeneity from the cell extract of H. pylori. The purified enzyme consisted of heavy and light subunits with molecular weights of 38 kDa and 21 kDa, respectively. N-terminal amino acid sequence of heavy and light subunits revealed that H. pylori GGT was processed into 3 parts for a signal peptide of 27 amino acid residues, a heavy subunit of 352 residues, and a light subunit of 188 residues during translation. The reaction rate for hydrolysis of ${\gamma}$-GpNA was 84.4 ${\mu}mol/min$ per milligram of protein, and that for the ${\gamma}$-glutamyl transfer from ${\gamma}$-GpNA to gly-gly was 23.8 ${\mu}mol/min$ per milligram of protein. The apparent Km values of H. pylori GGT for ${\gamma}$-glutamyl compounds were on the order of $10^{-3}$ to $10^{-4}$ M and those for acceptor peptides and amino acids were on the order of $10^{-1}$ to $10^{-2}$ M. The GGT protein kept approximately 80% of the initial enzymatic activity on incubation at $60^{\circ}C$ for 15 min. The optimum temperature and pH for reactions of both hydrolysis and transpeptidation were $40^{\circ}C$ and 9.0, respectively. The transpeptidation and hydrolysis reactions catalyzed by H. pylori GGT were strongly inhibited by L-Gln and moderately inhibited by L-Ala, L-Ser, ${\beta}$-chloro-L-Ala, and L-Glu. These results demonstrated that the biochemical properties of H. pylori GGT are different from those of other bacterial GGTs. Further, H. pylori GGT might degrade glutathione in the gastric mucous layer of humans if the enzyme could be secreted in the bacterial niches.

Comparison of the rebound tonometer (TonoVet^®) with the applanation tonometer (TonoPen XL^®) in normal Eurasian Eagle owls (<i>Bubo bubo</i>)

Jeong, Man-Bok,Kim, Young-Jun,Yi, Na-Young,Park, Shin-Ae,Kim, Won-Tae,Kim, Se-Eun,Chae, Je-Min,Kim, Jong-Taek,Lee, Hang,Seo, Kang-Moon Blackwell Publishing Inc 2007 Veterinary ophthalmology Vol.10 No.6

<P>Abstract</P><P>Objective </P><P>To examine the feasibility and accuracy of a handheld rebound tonometer, TonoVet<SUP>®</SUP>, and to compare the intraocular pressure (IOP) readings of the TonoVet<SUP>®</SUP> with those of an applanation tonometer, TonoPen XL<SUP>®</SUP>, in normal Eurasian Eagle owls.</P><P>Animals studied </P><P>Ten clinically normal Eurasian Eagle owls (20 eyes).</P><P>Procedures </P><P>Complete ocular examinations, using slit-lamp biomicroscopy and indirect ophthalmoscopy, were conducted on each raptor. The IOP was measured bilaterally using a rebound tonometer followed by a topical anesthetic agent after 1 min. The TonoPen XL<SUP>®</SUP> tonometer was applied in both eyes 30 s following topical anesthesia.</P><P>Results </P><P>The mean ± SD IOP obtained by rebound tonometer was 10.45 ± 1.64 mmHg (range 7–14 mmHg), and by applanation tonometer was 9.35 ± 1.81 mmHg (range 6–12 mmHg). There was a significant difference (<I>P =</I> 0.001) in the IOP obtained from both tonometers. The linear regression equation describing the relationship between both devices was <I>y</I> = 0.669<I>x</I> + 4.194 (<I>x</I> = TonoPen XL<SUP>®</SUP> and <I>y</I> = TonoVet<SUP>®</SUP>). The determination coefficient (<I>r</I><SUP>2</SUP>) was <I>r</I><SUP>2</SUP> = 0.550.</P><P>Conclusions </P><P>The results suggest that readings from the rebound tonometer significantly overestimated those from the applanation tonometer and that the rebound tonometer was tolerated well because of the rapid and minimal stress-inducing method of tonometry in the Eurasian Eagle owls, even without topical anesthesia. Further studies comparing TonoVet<SUP>®</SUP> with manometric measurements may be necessary to employ rebound tonometer for routine clinical use in Eurasian Eagle owls.</P>

사람 비만세포주에서 Clozapine과 Fluoxetine에 의한 케모카인 및 케모카인 수용체의 상이한 발현

유영민,김종우,조정제,임강현 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.2

Objectives : It has been suggested that the immune system has a role in the pathophsiology of neuropsychiatric diseases. There are some reports that clozapine and fluoxetine affect on cytokine networks. Recently, it has been known that chemokines have chemotactic effect, and modulate a number of biological responses including the process of inflammation and the maintenance of CNS homeostasis. In the present study, we investigated the effect of clozapine or fluoxetine on the expression of chemokines and their receptors. Methods : Human mast cells(HMC-1) was incubated with phorbol myristate acetate(PMA, 100ng/㎖) and calcium ionophore A23187(350ng/㎖) for 3 hours. Colzapine(10^-7M) or fluoxetine(10^-7M) were pretreated for 1 hour. RT-PCR was performed for the detection of expression of various chemokines and chemokine receptors. Results : after treatment of clozapine, the expression of MCP-1, MIP-1β, CCR3,CXCR2, CXCR3 and CXCR4 were lower than the PMA/Ca ionophore-treated group, while the expression of MIP-1α, RANTES and IL-8 were not changed. However, fluoxetine was not affected the changes of expression of various chemokines and chemokine receptors. Conclusion : This result indicates that clozapine may affect on the expression of chemokines and chemokine receptors. Therefore, this study could, in part, provide the important basic data on the explanation of side effects of clozapine, such as fever and pancreatitis.

성선자극호르몬유리호르몬 길항제인 Antide가 수컷 생쥐의 유해감각예민도에 미치는 영향

박정현,박제민,김명정,이국희,최상헌,장세헌 대한생물치료정신의학회 2001 생물치료정신의학 Vol.7 No.1

To investigate testosterone effect on nociception, tail flick latency(TFL, sec, 50±1℃) was measured before and after administration of antide(a gonadotropin releasing hormone antagonist) in male mice(Institute of Cancer Research, age of 7-8 weeks, weight 30.5-37.5gm). Testosterone replacement effect on TFL was also examined in antide pre-treated male mice. Experiment 1:30 male mice were randomized into 3 groups(N=10 each). Antide 100㎍/kg, 300㎍/kg or same volume(5.7ml/kg) of 0.2% bovine serum albumin was administered intraperitoneally. TFL was measured before and at 3,6, 9, 12 and 24 hours after injection. Experiment 2 : 40 novice male mice were randomized into 2 groups(N=20 each) and both groups were pre-treated with antide 300㎍/kg i.p.6 hours after antide injection, testosterone 1mg/kg or same volume(5.7ml/kg) of sesame oil was administered i.p. TFL was measured before and 6 hours after antide pre-treatment and 30 min after testosterone/vehicle injection. 1) TFL was significantly shortened by antide in dose dependent manner, In control group, baseline TFL(mean±SD) and those measured at 3,6,9,12 and 24 hours after injection were 4.8±0.7, 5.6±0.7, 5.3±0.6, 5.4±0.6 and 4.7±0.6 sec, respectively. In antide 100㎍/kg group, TFLs were 5.2±0.9, 5.1 ±1.1, 4.2±0.9, 4.4±0.8, 5.1±0.8, and 4.7±0.8 sec, respectively. Compared with baseline, significant hyperalgesia appeared 6 and 9 hours after treatment. TFL measured at 6 hours after treatment was significantly shorter than control. In antide 300㎍/kg group, TFLs were 5.6±0.4, 4.5±0.9, 4.3±0.6, 3.9±1.0, 4.6±0.8 and 4.7±0.9 sec. Significant hyperalgesia appeared 3 hours after treatment and continued thereafter. TFLs measured at 3, 6 and 9 hours after treatment were significantly shorter than control, and TFL at 9 hours was significantly shorter than antide 100㎍/kg group. 2) Hyperalgesia induced by antide pre-treatment was recovered by testosterone replacement. In control group. TFL was shortened by antide pre-treartment(baseline : 6.1±1.0 sec ,6 hr after antide : 4.7±1.0 sec) and there was no significant change after vehicle injection(4.6±0.8 sec). In testosterone group, shortening of TFL induced by antide pre-treatment(baseline: 6.2±0.8 sec; 6 hr after antide: 4.6±0.9 sec) disappeared after testosteronen replacement(0.6±0.8sec). From these results, it is suggested that testosterone has a role of maintaining baseline antinociception and acute decrease in testosterone level results in hyperalgesia.

뇌하수체 종양 제거술 시행 후 뒤늦게 발생한 횡문근 융해증과 동반된 중추성 열

장제혁,최규남,김일환,노은지,김윤정,유충헌,고정해,박봉수,김태균,권민정,이순희,박정현 인제대학교 2008 仁濟醫學 Vol.29 No.-

Body temperature is controlled by thermoregulatory center of the hypothalamus. We report a case of 24 years old man with central fever. He was subjected to a partial excision of pituitary tumor compressing optic chiasm four years ago. He has received hormonal therapy for panhypothyroidism after removal of pituitary tumor. And He received gamma knife operation for partially contrast-enhancing masses in suprasellar and both hypothalamic areas that is probably postoperatively remnant or recurrent tumor of pituitary adenoma. One year after gamma knife operation, he presented with a febrile syndrome of unknown origin including rhabdomyolysis. All usual investigations proved negative. We diagnosed him as central fever with rhabdomyolysis. He received medical ICU care with cooling bed, ice pack. And his symptom improved. Postoperative hyperthermia may result following resection of the pituitary tumor. When central fever is suspected taking note of past history, a quick recognition of course of fever can help reduce the using of unnecessary antibiotics and hospital stay.

Epstein-Barr 바이러스 형질전환법을 이용한 파상풍 톡소이드에 대한 사람 단세포군 항체의 생산

유승민,조정제,호순태,하윤문 大韓免疫學會 1993 大韓免疫學會誌 Vol.15 No.-

For production of tetanus toxoid(TT) specific human monoclonal antibodies, anti-TT antibody secreting peripheral B lymphocytes were separated by rosetting with TT-coated SRBC. And, B lymphoblastoid cell line(BLCL) was established by Epstein-Barr Virus(EBV) transformation methods. Stable BLCLs were established after three times of cloning by limiting dilution. To establish the maximal antibody producing condition, several environmental factors were tested. The optimal condition for maximum antibody prodiction was 4 day culture of 1 x 105cells/ml concentration in RPMI 1640 complete culture media supplemented with 20% fetal calf serum, and the maximum concentration of secreted antibody was about 900ng/ml. The antibody production of BLCL was decreased during long-term culture after establishment of cell line, but antibody production was maintained by repeated cloning by limiting dilution.

G-CSF로 체내 증폭된 골수를 이용한 동종 조혈모세포이식

이종욱,김정아,민창기,김희제,엄현석,박수정,서정곤,김동욱,홍영선,민우성,김춘추,김동집 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

연구배경: 이식시 주입되는 골수세포수는 생착 속도 및 생존율과 밀접한 관계가 있으나, 임상적으로 환자의 체중이 공여자에 비해 지나치게 많을 때 단위 체중당 환자에게 주입되는 세포의 양이 적어 문제가 될 수 있다. 방법: 저자들은 가톨릭 조혈모세포이식 센터에서 동종 골수이식을 시행한 환자들 중 환자의 체중이 공여자에 비해 10kg이상 많은 경우 골수 채취 전에 공여자에게 3일간 피하로 G-CSF(10ug/kg/day)를 투여하여 골수를 체내(in vivo) 증폭시킨 후 골수이식을 시행한 25예의 환자를 대상으로 고식적인 방법으로 골수이식을 시행한 위험인자가 일치되는 대조군과 비교하여 이식된 세포수, 혈구의 회복속도 및 이식편대 숙주반응(GVHD)의 발생율, 그리고 생존율 등을 비교 분석하였다. 결과: 단기간의 G-CSF 투여로 증폭된 골수의 총 유핵세포수, 단핵구수는 대조군에 비해 3-5배, CD34 + 세포수는 6배 증폭되었으며, 두 군간에 세포의 면역표현형(CD4, CD5, CD7, CD8, CD20)의 차이는 없었다. 중성 백혈구 수가 0.5×10^(9)/L 이상 회복되는 시기는 두 군간의 차이가 없었으나(15.5일 vs 16일; p=0.131), 혈소판 수가 30×10^(9)/L 이상으로 회복되는 시기는 G-CSF 투여군에서 의의있게 단축되었다(20일 vs 26일; p=0.013). 두 군간 급성 및 만성 GVHD의 발생률과 정도의 차이는 없었으며, 이식 후 재발 및 생존율의 차이도 없었다. 결론: 이식전 공여자에게 단기간 G-CSF를 주사하여 생체내에서 골수 조혈모세포를 증폭시킨 후 이식하는 방법은 공여자와 환자의 심각한 체중 차이로 인해 단위체중당 이식되는 조혈모세포양이 부족한 환자들에게 안전하고 유용한 방법일 뿐만 아니라 GVHD의 증가 없이 빠른 혈구회복을 기대할 수 있는 이식기법이라고 생각한다. 향후 증폭된 골수 조혈모세포의 특성 연구 및 이의 효용성을 확인하기 위한 전향적인 연구가 필요하리라고 생각된다. Background: Sufficient stem cell doses are necessary to overcome engraftment failure in allogeneic bone marrow transplantation(BMT). Cell doses harvested may depend on body weight (BW) difference between donor and recipient. In practice, it is important to achieve large number of stem cells from donor who were lower BW than that of recipient. Methods: We have tried to inject G-CSF(10ug/kg/day) subcutaneously for 3 days to the allogeneic donor with lower BW than recipient before harvest to increase BM inoculum. BM was infused into patients without any manipulation on day 5. A total 25 patients were enrolled; 12 AML, 6 ALL, 5 SAA and 2 CML(expansion group). We compared the expansion group with 25 historical control patients, matched for diagnosis and clinical characteristics, who underwent unprimed BMT. Results: Recipient BW is not different between the expansion and control group. However, allogeneic donors in the control group weigh heavier than those in the expansion group. The yield of TNC, MNC, and CD34^(+) cells from G-CSFprimed BM was significantly higher than that from unprimed BM. There was no difference in immunophenotyping analysis(CD4, CD5, CD7, CD8, CD20) between two groups. The median time reaching to absolute neutrophil count more than 0.5×10^(9)/L was not different(15.5 vs 16 days: p=0.131), but time to platelet recovery more than 30×10^(9)/L was significantly shorter for the patients who received G-CSF-primed BM (20 vs 26 days: p=0.013). There was no difference in the incidence of acute and chronic GVHD, relapse rate and overall survival between the two groups with a median follow-up of 13 months. Conclusion: These data suggest that the short-term administration of G-CSF to an allogeneic donor prior to BM harvest seems to be a feasible method to achieve an adequate number of cell doses for patients who weigh higher than donors. Randomized, prospective study is needed to evaluate the efficacy of allogeneic BMT using in vivo expansion of BM by G-CSF.

전경대원에서 발생한 결핵의 임상 양상

문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구

김우진,심주철,공보금,강제욱,문정준,김정은,김민걸,박민경,김성진,김현정,정도운 대한생물치료정신의학회 2011 생물치료정신의학 Vol.17 No.2

Objectives:This study was to identify weight & metabolic changes in first-episode psychotic patients with antipsychotics use and investigate the differences of weight & metabolic changes between first-episode psychotic patients and controls with antipsychotics use. Method:In this retrospective study, twenty eight first-episode psychotic patients and twenty eight controls with schizophrenia, schizoaffective or bipolar disorder defined by DSM-IV criteria were included. Information about demographic and clinical characteristics of the subjects was gathered from the medical records. Also body weight, sBP, dBP, fasting glucose, lipid profile and WBC count were evaluated before and after antipsychotics use. Rogistic regression was conducted to assess factors associated with weight gain. Results:First-episode psychotic patients showed more weight and BMI changes than controls after antipsychotics use, and these changes continue over 12 months. On the other hand, there were no significant factors associated with weight gain. Conclusion:The results of present study suggest that antispychotics is one of the major causes inducing weight gain of psychotic patients and antipsychotics-induced weight gain is more vulnerable to drug-naive first-episode psychotic patients.