관상동맥 누공에 의한 급성 심근 경색 1예

서유승,최재웅,송창섭,조용범,양진수,박준섭,정인수 대한내과학회 2003 대한내과학회지 Vol.65 No.2

관상동맥 동정맥루 기형은 매우 드문 질환으로 치료가 불필요한 경우가 대부분이나 coronary steal 현상으로 인해 증상이 발생하거나 합병증이 발생한 환자에 대해선 치료를 요한다. 최근에는 시술에 적합한 누공을 가진 선택된 환자군을 대상으로 카테터를 이용한 중재적 시술이 시행되어 수술적 치료와 유사한 결과를 얻고 있다. 저자들은 젊은 남자에서 관상동맥 동정맥루 기형과 동반된 급성 심근 경색증을 진단하여 비 수술적 방법인 카테타 코일 색전술로 성공적 치료 후 증상 및 심근 재관류에 호전을 보인 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.

골수염의 진단에 있어서의 Tc-99m Hexamethylpropylene amine oxime 백혈구 스캔의 임상적 유용성

최상호,김양수,정준원,정진원,추은주,서동대,배인규,양승오,우준희,류지소 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

배경 : 골수염의 진단에 있어 Technetium-99m을 이용한 삼상 골스캔(Tc-99m MDP스캔)은 단순방사선 검사상 정상소견을 보이는 경우에 쓰이는 1차적 검사로 매우 높은 민감도를 보인다. 그러나 Tc-99m MDP 스캔은 골절이나, 정형외과적 삽입물, 신경병적 관절병변과 같이 뼈의 재형성이 증가되는 상황에서도 양성소견을 보여 특이도가 낮은 단점이 있다. 이러한 단점을 보완하고자 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 골수염이 의심되어 Tc-99m HMPAO 백혈구 스캔을 시행했던 15명의 의무기록을 후향적으로 분석하였다. 골수염의 확진은 임상관찰 소견과 배양검사 결과와 병리소견을 기준으로 하였다. 결과 : 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 민감도와 특이도는 각각 100%와 78%였고 Tc-99m HMPAO 스캔의 경우는 100%와 18%였다. 가장 흔한 원인균은 methicillin-resistant S. aureus였다. Tc-99m MDP 스캔에서 양성소견을 보였던 환자중 3명의 환자가 Tc-99m HMPAO 백혈구 스캔에서 음성 소견을 보였으며 이 환자들은 추적관찰상 골수염이 없는 것으로 확인되었다. 결론 : Tc-99m HMPAO 백혈구 스캔은 골수염의 존재를 진단하는데 있어 민감도와 특이도가 높으며, 특히 뼈의 재형성이 증가되어 Tc-99m MDP 스캔의 특이도가 낮게 나타나는 상황에서 유용하리라 사료된다. Background Three phase bone scintigraphy, performed with technetium-labeled diphosphonates (Tc-99m MDP scan), is the very sensitive radionuclide procedure of choice for diagnosing osteomyelitis. But, Tc-99m MDP scan is less specific when bone remodeling is increased. To overcome this limitation, we evaluated the diagnostic value of technetium-99m hexamethylpropyleneamine oxime (HMPAO) labeled leukocyte scan in osteomyelitis. Methods : We retrospectively reviewed 15 patients with suspected osteomyelitis who performed Tc-99m HMPAO labeled leukocyte scan. The diagnosis of osteomyelitis was based on clinical course and bacterial culture, and pathologic findings. Results The sensitivity and specificity of Tc-99m HMPAO leukocyte scan was 100% and 78%, and those of Tc-99m MDP scan was 100% and 18%, respectively. The most common organism was Methicilein-Resistant S. aureus. Among the patients that showed persistent accumulation on Tc-99m MDP scan, three patients showed no uptake on Tc-99m HMPAO leukocyte scan and these patients were confirmed that had no osteomyelitis. Conclusion : Tc-99m HMPAO leukocyte scan is a useful test for determining the presence or absence of osteomyelitis, especially under condition that bone remodelin is increased.

처리 방법이 다른 표면이 임플랜트의 골유착 및 안정성에 미치는 영향

양성욱,임헌송,조인호,Yang, Seoung-Wook,Lim, Heon-Song,Cho, In-Ho 대한치과보철학회 2006 대한치과보철학회지 Vol.44 No.5

Purpose: This experiment examined the effect of different surface treatment on the osseointegration and stability of implants. Material and methods: In this study, 40 each of machined, SLA and RBM implants, which are the most commonly used implants, were implanted into the tibia of 20 normal rabbits using $OsseoCare^{TM}$. The rabbits were sacrificed after 1 week, 4 weeks, 8 weeks and 12 weeks for implant stability analysis, removal torque analysis, histologic and histomorphometric analysis. Result : ISQ showed significant difference between Machined and RBM at first week and at 4 weeks. There was significant difference between Machined and both SLA and RBM(p<0.05) but after 8 weeks there were no significant difference between each group. In the removal torque, RBM showd significantly higher values than SLA and Machined surface at 1st week. At 4th and 12th week, there was significant difference between Machined and SLA, RBM(p<0.05). In the bone to implant contact variable, there was no significant difference between each surface treatment method. In the Machined surface group, there was no significant difference between each time interval. but in SLA group, there were significant differences between the 1st week and 12th week and in RBM group, there were significant differences between the 1st week and 8th, 12th week and between 4th and 12th week(p<0.05). The bone area showed significantly higher values in SLA and RBM compared to Machined surface 1st and 8th week and significantly higher values in SLA than Machined surface at the 4th week(p<0.05). Conclusion: The roughened surface of implants showed positive effect in the early stages of implantation and assisted in bone formation After the bone formation stage, there was no statistical difference between Machined and roughened surface groups. In dental implantation, where initial stability is critical to the success of implants, the use of roughened surface implants should assist in reducing the healing period after implantation.

Development of the Korean Developmental Screening Test for Infants and Children (K-DST)

Chung, Hee Jung,Yang, Donghwa,Kim, Gun-Ha,Kim, Sung Koo,Kim, Seoung Woo,Kim, Young Key,Kim, Young Ah,Kim, Joon Sik,Kim, Jin Kyung,Kim, Cheongtag,Sung, In-Kyung,Shin, Son Moon,Oh, Kyung Ja,Yoo, Hee-Jeo The Korean Pediatric Society 2020 Clinical and Experimental Pediatrics (CEP) Vol.63 No.11

Background: Most developmental screening tools in Korea are adopted from foreign tests. To ensure efficient screening of infants and children in Korea, a nationwide screening tool with high reliability and validity is needed. Purpose: This study aimed to independently develop, standardize, and validate the Korean Developmental Screening Test for Infants and Children (K-DST) for screening infants and children for neurodevelopmental disorders in Korea. Methods: The standardization and validation conducted in 2012-2014 of 3,284 subjects (4-71 months of age) resulted in the first edition of the K-DST. The restandardization and revalidation performed in 2015-2016 of 3.06 million attendees of the National Health Screening Program for Infants and Children resulted in the revised K-DST. We analyzed inter-item consistency and test-retest reliability for the reliability analysis. Regarding the validation of K-DST, we examined the construct validity, sensitivity and specificity, receiver operating characteristic curve analysis, and a criterion-related validity analysis. Results: We ultimately selected 8 questions in 6 developmental domains. For most age groups and each domain, internal consistency was 0.73-0.93 and test-retest reliability was 0.77-0.88. The revised K-DST had high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979. The test supported construct validity by distinguishing between normal and neurodevelopmentally delayed groups. The language and cognition domain of the revised K-DST was highly correlated with the K-Bayley Scales of Infant Development-II's Mental Age Quotient (r=0.766, 0.739), while the gross and fine motor domains were highly correlated with Motor Age Quotient (r=0.695, 0.668), respectively. The Verbal Intelligence Quotient of Korean Wechsler Preschool and Primary Scales of Intelligence was highly correlated with the K-DST cognition and language domains (r=0.701, 0.770), as was the performance intelligence quotient with the fine motor domain (r=0.700). Conclusion: The K-DST is reliable and valid, suggesting its good potential as an effective screening tool for infants and children with neurodevelopmental disorders in Korea.

골절부위에 생긴 혈종의 골막하 이식이 골형성에 미치는 영향에 관한 실험적 연구 - 골스캔 소견을 중심으로 -

이명철(Myung Chul Lee),양승오(Seoung Oh Yang),강흥식(Hung Sik Kang),장기현(Kee Hyun Chang),구경회(Kyung Hoi Koo),성상철(Sang Chul Seung),박인애(In Ae Park) 대한핵의학회 1990 핵의학 분자영상 Vol.24 No.1

N/A It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hamatoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control gorups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, seria bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, a11 in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimentaI models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

Comparison of High MRI T1 Signals with Manganese Concentration in Brains of Cynomolgus Monkeys After 8 Months of Stainless Steel Welding-Fume Exposure

Park, Jung Duck,Chung, Yong Hyun,Kim, Choong Yong,Ha, Chang Soo,Yang, Seoung Oh,Khang, Hyun Soo,Yu, In Kyu,Cheong, Hae Kwan,Lee, Jong Seong,Song, Chang-Woo,Kwon, Il Hoon,Han, Jeong Hee,Sung, Jae Hyuck Informa Healthcare 2007 Inhalation toxicology Vol.19 No.11

<P> Several pharmacokinetic studies on inhalation exposure to manganese (Mn) have already demonstrated that Mn readily accumulates in the olfactory and brain regions. However, a shortening of the magnetic resonance imaging (MRI) T1 relaxation time or high T1 signal intensity in specific sites of the brain, including the globus pallidus and subcortical frontal white matter, as indicative of tissue manganese accumulation has not yet been clearly established for certain durations of known doses of welding-fume exposure in experimental animals. Accordingly, to investigate the movement of manganese after welding-fume exposure, six cynomolgus monkeys were acclimated and assigned to three dose groups: unexposed, low dose (31 mg/m3 total suspended particulate [TSP], 0.9 mg/m3 of Mn), and high dose (62 mg/m3 TSP, 1.95 mg/m3 of Mn) of total suspended particulate. The primates were exposed to manual metal arc stainless steel (MMA-SS) welding fumes for 2 h per day in an inhalation chamber system equipped with an automatic fume generator. Magnetic resonance imaging (MRI) studies were conducted before the initiation of exposure and thereafter every month. The tissue Mn concentrations were then measured after a plateau was reached regarding the shortening of the MRI T1 relaxation time. A dose-dependent increase in the Mn concentration was found in the lungs, while noticeable increases in the Mn concentrations were found in certain tissues, such as the liver, kidneys, and testes. Slight increases in the Mn concentrations were found in the caudate, putamen, frontal lobe, and substantia nigra, while a dose-dependent noticeable increase was only found in the globus pallidus. Therefore, the present results indicated that a shortening of the MRI T1 relaxation time corresponded well with the Mn concentration in the globus pallidus after prolonged welding-fume exposure.</P>

A Pressure Adjustment Protocol for Programmable Valves

Kim, Kyoung-Hun,Yeo, In-Seoung,Yi, Jin-Seok,Lee, Hyung-Jin,Yang, Ji-Ho,Lee, Il-Woo The Korean Neurosurgical Society 2009 Journal of Korean neurosurgical society Vol.46 No.4

Objective : There is no definite adjustment protocol for patients shunted with programmable valves. Therefore, we attempted to find an appropriate method to adjust the valve, initial valve-opening pressure, adjustment scale, adjustment time interval, and final valve-opening pressure of a programmable valve. Methods : Seventy patients with hydrocephalus of various etiologies were shunted with programmable shunting devices (Micro Valve with $RICKHAM^{(R)}$ Reservoir). The most common initial diseases were subarachnoid hemorrhage (SAH) and head trauma. Sixty-six patients had a communicating type of hydrocephalus, and 4 had an obstructive type of hydrocephalus. Fifty-one patients had normal pressure-type hydrocephalus and 19 patients had high pressure-type hydrocephalus. We set the initial valve pressure to $10-30\;mmH_2O$, which is lower than the preoperative lumbar tapping pressure or the intraoperative ventricular tapping pressure, conducted brain computerized tomographic (CT) scans every 2 to 3 weeks, correlated results with clinical symptoms, and reset valve-opening pressures. Results : Initial valve-opening pressures varied from 30 to $180\;mmH_2O$ (mean, $102{\pm}27.5\;mmH_2O$). In high pressure-type hydrocephalus patients, we have set the initial valve-opening pressure from 100 to $180\;mmH_2O$. We decreased the valve-opening pressure $20-30\;mmH_2O$ at every 2- or 3-week interval, until hydrocephalus-related symptoms improved and the size of the ventricle was normalized. There were 154 adjustments in 81 operations (mean, 1.9 times). In 19 high pressure-type patients, final valve-opening pressures were $30-160\;mmH_2O$, and 16 (84%) patients' symptoms had nearly improved completely. However, in 51 normal pressure-type patients, only 31 (61%) had improved. Surprisingly, in 22 of the 31 normal pressure-type improved patients, final valve-opening pressures were $30\;mmH_2O$ (16 patients) and $40\;mmH_2O$ (6 patients). Furthermore, when final valve-opening pressures were adjusted to $30\;mmH_2O$, 14 patients symptom was improved just at the point. There were 18 (22%) major complications : 7 subdural hygroma, 6 shunt obstructions, and 5 shunt infections. Conclusion : In normal pressure-type hydrocephalus, most patients improved when the final valve-opening pressure was $30\;mmH_2O$. We suggest that all normal pressure-type hydrocephalus patients be shunted with programmable valves, and their initial valve-opening pressures set to $10-30\;mmH_2O$ below their preoperative cerebrospinal fluid (CSF) pressures. If final valve-opening pressures are lowered in 20 or $30\;mmH_2O$ scale at 2- or 3-week intervals, reaching a final pressure of $30\;mmH_2O$, we believe that there is a low risk of overdrainage syndromes.

사과 의존성 운동 유발성 아나필락시스 환자

양민석 ( Min Suk Yang ),이소희 ( So Hee Lee ),김경묵 ( Kyung Mook Kim ),권혁수 ( Hyouk Soo Kwon ),김덕인 ( Deok In Kim ),박창한 ( Chang Han Park ),손성욱 ( Seoung Wook Son ),박흥우 ( Heung Woo Park ),장윤석 ( Yoon Seok Chang ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.3

We here report a case with apple-dependent exercise-induced anaphylaxis, the first case in Korea. A 23-year-old Korean female patient presented with urticaria, angioedema, and dizziness during mountain climbing. A detailed clinical history revealed that she ingested apple 30 minutes before mountain climbing. Prick to prick skin test to apple showed a positive result. The exercise provocation test or the oral challenge test alone showed a negative result. However, the exercise provocation test after apple ingestion resulted in severe anaphylactic reaction. She was diagnosed as having food-dependent exercise-induced anaphylaxis to apples, and was instructed to avoid exercise after apple ingestion in the future. (Korean J Asthma Allergy Clin Immunol 2006;26: 242-245)

Silencing of cytosolic NADP⁺-dependent isocitrate dehydrogenase by small interfering RNA enhances the sensitivity of HeLa cells toward staurosporine

Lee, Su-Min,Park, Sin Young,Shin, Seoung Woo,Kil, In Sup,Yang, Eun Sun,Park, Jeen-Woo Informa UK (TaylorFrancis) 2009 Free radical research Vol.43 No.2

<P>Staurosporine induces the production of reactive oxygen species, which play an important causative role in apoptotic cell death. Recently, it was demonstrated that the control of cellular redox balance and the defense against oxidative damage is one of the primary functions of cytosolic NADP(+)-dependent isocitrate dehydrogenase (IDPc) by supplying NADPH for antioxidant systems. The present report shows that silencing of IDPc expression in HeLa cells greatly enhances apoptosis induced by staurosporine. Transfection of HeLa cells with an IDPc small interfering RNA (siRNA) markedly decreased activity of IDPc, enhancing the susceptibility of staurosporine-induced apoptosis reflected by DNA fragmentation, cellular redox status and the modulation of apoptotic marker proteins. These results indicate that IDPc may play an important role in regulating the apoptosis induced by staurosporine and the sensitizing effect of IDPc siRNA on the apoptotic cell death of HeLa cells offers the possibility of developing a modifier of cancer chemotherapy.</P>

대량출혈을 동반한 상행결장 허혈성 대장염 1예

김시민,박영숙,정인수,양진수,서유승,주연호,김태헌,조윤주,한준길,주종은 大韓消化器內視鏡學會 2002 Clinical Endoscopy Vol.25 No.6