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Meckel 게실의 합병증으로 수술 받은 환아의 임상양상
김현아,최금자,한후재 이화여자대학교 2003 EMJ (Ewha medical journal) Vol.26 No.2
Objectives : The purpose of study is to assess the clinical characteristics of complicated Meckel's diverticulum in children. Methods : A retrospective review of pediatric cases of complicated Meckel's diverticulae that were surgically treated at Ewha Womans University Hospital from 1985 was performed. The charts were reviewed for the age and sex of the patients, operation finding, treatment, and outcome. Results : A total 13 patients with a complicated Meckel's diverticulum were identified. There were 8 boys(61.5%) and 5 girls (38.5%) with a mean age of 5.3 years (range, 1month to 14years). Presenting signs and symptoms included digestive hemorrhage (6), intestinal obstruction(4), perfora-tion (1), intussusception due to inverted Meckel's diverticulum (1) and diverticulitis (1). A ^(99m) technetium pertechnetate scintiscan was positive in 3 of 4 patients. Barium contrast studies and colonoscopys were not diagnostic. The mean distance from the ileocecal valve to the diverticulum was 47.0±15.7cm. Average length of the diverticulum was approximately 4.7±3.0cm. Segmen-tal small bowel resection including Meckel's diverticulum (84.6%) or wedge excision(15.4%) was done for treatment. In the bleeding group, ectopic gastric mucosa was present in 5 of 6 patients. Postoperative morbidity and mortality was each 0%. Conclusion : The results of this study draw attention to the fact that the complicated Meckel's diverticulum must be suspected in children with acute abdomen or gastrointestinal bleeding. 목적: Meckel 게실의 합병증의 원인이 되어 수술적 치료를 받은 소아 환자들의 임상적 증상과 수술소견, 병리학적 소견을 분석하여 이들의 특징을 알아보고자 하였다. 방법 : 1985년 이후 이화대학교의료원에서 Meckel 게실의 합병증으로 수술을 받은 15세 이하의 소아들 대상으로 하여 의무기록과 조직병리 검사 결과를 조사하였다. 결과: 총 13명의 환아가 Meckel 게실의 합병증으로 수술을 받았으며 남녀의 비는 1.6:1로 남아에서 호발하는 경향을 보였으며, 수술 시 평균 연령은 5.3세였다. 수술의 원인이 된 Meckel 게실의 진단은 장출혈 6예, 장폐색 4예,Meckel 게실의 천공 1예, 장중첩 1예, 게실염 1예였다. 회맹판에서 게실까지의 평균길이는 47.0±15.7cm이었으며, 소장부분절제술과 쐐기절제술이 각각 84.6%와 15.4%에서 시행되었다. 장출혈을 나타내었던 환아 6명 중 5예에서 병리조직에서 이소성 위 점막이 관찰되었다. 술 후 합병증과 사망예는 없었다. 결론 : 소아에서 외과적 급성 복증이나 장출혈의 증상이 나타날 경우, Meckel 게실의 합병증의 가능성에 대한 외과의의 인식이 필요하다.
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Bae, Sun Hyun,Kim, Mi-Sook,Cho, Chul Koo,Kim, Kum Bae,Lee, Dong Han,Han, Chul Ju,Park, Su Cheol,Kim, Young Han The Korean Academy of Medical Sciences 2013 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.28 No.2
<P>The purpose of this study was to assess the feasibility and efficacy of stereotactic ablative radiotherapy (SABR) for liver tumor in patients with Barcelona Clinic Liver Cancer (BCLC)-C stage hepatocellular carcinoma (HCC). We retrospectively reviewed the medical records of 35 patients between 2003 and 2011. Vascular invasion was diagnosed in 32 patients, extrahepatic metastases in 11 and both in 8. Thirty-two patients were categorized under Child-Pugh (CP) class A and 3 patients with CP class B. The median SABR dose was 45 Gy (range, 30-60 Gy) in 3-5 fractions. The median survival time was 14 months. The 1- and 3-yr overall survival (OS) rate was 52% and 21%, respectively. On univariate analysis, CP class A and biologically equivalent dose ≥ 80 Gy<SUB>10</SUB> were significant determinants of better OS. Severe toxicity above grade 3, requiring prompt therapeutic intervention, was observed in 5 patients. In conclusion, SABR for BCLC-C stage HCC showed 1-yr OS rate of 52% but treatment related toxicity was moderate. We suggest that patients with CP class A are the best candidate and at least SABR dose of 80 Gy<SUB>10</SUB> is required for BCLC-C stage.</P>
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Han, Ji-Youn,Lee, Soo Hyun,Lee, Geon Kook,Yun, Tak,Lee, Young Joo,Hwang, Kum Hui,Kim, Jin Young,Kim, Heung Tae Springer Berlin Heidelberg 2015 Cancer chemotherapy and pharmacology Vol.75 No.3
<P><B>Purpose</B></P><P>Vorinostat has been shown to overcome resistance to gefitinib. We performed a phase I/II study combining gefitinib with vorinostat in previously treated non-small cell lung cancer (NSCLC).</P><P><B>Methods</B></P><P>A 3 + 3 dose-escalation design was used to determine maximum tolerated dose (MTD) and recommended phase II dose (RP2D). Three dose levels were tested: 250 mg/day gefitinib on days 1–28 and 200, 300 or 400 mg/day vorinostat on days 1–7, and 15–21 out of every 28 days. The primary endpoint was median progression-free survival (PFS).</P><P><B>Results</B></P><P>Fifty-two patients were enrolled and treated (43 in phase II). The median age was 59 years, 28 patients were male, 44 had adenocarcinoma, 29 had never smoked, and 36 had undergone one prior treatment. Twenty-two patients exhibited sensitive EGFR mutations. Planned dose escalation was completed without reaching the MTD. The RP2D was 250 mg gefitinib and 400 mg vorinostat. In 43 assessable patients in phase II, the median PFS was 3.2 months; the overall survival (OS) was 19.0 months. There were 16 partial responses and six cases of stable disease. In EGFR-mutant NSCLC, response rate was 77 %, median PFS was 9.1 months, and median OS was 24.1 months. The most common adverse events were anorexia and diarrhea.</P><P><B>Conclusions</B></P><P>Treatment with 250 mg gefitinib daily with biweekly 400 mg/day vorinostat was feasible and well tolerated. In an unselected patient population, this combination dose did not improve PFS. However, this combination showed a potential for improving efficacy of gefitinib in EGFR-mutant NSCLC (NCT01027676).</P>
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Pupil Size in Relation to Cortical States during Isoflurane Anesthesia
Kum, Jeung Eun,Han, Hio-Been,Choi, Jee Hyun The Korean Society for Brain and Neural Science 2016 Experimental Neurobiology Vol.25 No.2
<P>In neuronal recording studies on anesthetized animals, reliable measures for the transitional moment of consciousness are frequently required. Previous findings suggest that pupil fluctuations reflect the neuronal states during quiet wakefulness, whose correlation was unknown for the anesthetized condition. Here, we investigated the pupillary changes under isoflurane anesthesia simultaneously with the electroencephalogram (EEG) and electromyogram (EMG). The pupil was tracked by using a region-based active contour model. The dose was given to the animal in a stepwise increasing mode (simulating induction of anesthesia) or in a stepwise decreasing mode (simulating emergence of anesthesia). We found that the quickly widening pupil action (mydriasis) characterizes the transitional state in anesthesia. Mydriasis occurred only in the light dose in the emergence phase, and the events were accompanied by an increase of burst activity in the EEG followed by EMG activity in 47% of the mydriasis events. Our findings suggest that recording such pupil changes may offer a noncontact monitoring tool for indexing the transitional state of the brain, particularly when a lower threshold dose is applied.</P>
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반응표면분석법을 통한 Arthrobacter sp.의 amylase 생산 최적화
김현도 ( Hyun Do Kim ),임영금 ( Young Kum Im ),최종일 ( Jong Il Choi ),한세종 ( Se Jong Han ) 한국화학공학회 2016 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.54 No.1
In this study, the physical factors for amylase production by Arthrobacter sp. were optimized using response surface methodology(RSM). Antarctic microorganism Arthrobacter sp. PAMC 27388 was obtained from the Polar and Alpine Microbial Collection(PAMC) at the Korea Polar Research Institute. This microorganism was confirmed for the excretion of amylase with Lugol`s solution. The amylase activity was after flask culture was as low as 1.66 mU/L before optimization. The physical factors including the inoculum volume, the initial culture pH, and the medium volume were chosen to be optimized for the enhanced amylase production. The calculated results using RSM indicate that the optimal physical factors were 2.49 mL inoculum volume, 6.85 pH and 42.87 mL medium volume with a predicted amylase production of 2.84 mU/L. The experimentally obtained amylase activity was 2.50 mU/L, which was a 150% increase compared to the level before optimization.
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