우관상동맥 개구부 완전 폐쇄가 동반된 대동맥 판상부 협착증 1례

임상현,김종진,김희열,진승원,전희경,노태호,채장성,김재형,홍순조,최규보,윤정섭,김치경 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

Medicinal Chemistry : EVALUATION OF CADMIUM-INDUCED NEPHROTOXICITY USING URINARY METABOLOMIC PROFILES IN SPRAGUE-DAWLEY MALE RATS

( Yu Kyung Lee ),( Eun Young Park ),( Shi Won Kim ),( Ji Yeon Son ),( Tae Hyung Kim ),( Won Gu Kang ),( Tae Chun Jeong ),( Kyu Bong Kim ),( Seung Jun Kwack ),( Jae Won Lee ),( Suh Mann Kim ),( Byung M 영남대학교 약품개발연구소 2015 영남대학교 약품개발연구소 연구업적집 Vol.25 No.-

The aim of this study was to investigate urinary metabolomics profiles associated with cadmium (Cd)-induced nephrotoxicity and their potential mechanisms. Metabolomic profiles were measured by high-resolution 1H-nuclear magnetic resonance (NMR) spectroscopy in the urine of rats after oral exposure to CdCl2 (1, 5, or 25 mg/kg) for 6 wk. The spectral data were further analyzed by a multivariate analysis to identify specific urinary metabolites. Urinary excretion levels of protein biomarkers were also measured and CdCl2 accumulated dose-dependently in the kidney. High-dose (25 mg/kg) CdCl2 exposure significantly increased serum blood urea nitrogen (BUN), but serum creatinine (sCr) levels were unchanged. High-dose CdCl2 (25 mg/kg) exposure also significantly elevated protein-based urinary biomarkers including osteopontin, monocyte chemoattractant protein-1 (MCP-1), kidney injury molecules-1 (Kim-1), and selenium-bingding protein 1 (SBP1) in rat urine. Under these conditions, six urinary metabolites (citarate, serine, 3-hydroxyisovalerate, 4-hydroxyphentllactate, dimethylamine, and betaine) were involved in mitochondrial energy metabolism. In addition, a few number of amino acids such as glycine, glutamate, tyrosine, proline, or phentlalanine and carbohydrate (glucose) were altered in urine afrer CdCl2 exposure. In particular, the metabolites involved in the glutathione biosynthesis pathway, including cysteine, serine, methionine, and glutamate, were markedly decreased compared to the control. Thus, these metabolites are potential biomarkers for detection of Cd-induced nephrotoxicity. Our results further indicate that redox metabolomics pathways may be associated with Cd-mediated chronic kidney injury. These findings provide a biochemical pathway for better understanding of cellulat mechanism underlying Cd-induced renal injury in hunmans.

요하지통 환자에서 두 개의 캐눌라를 이용한 박동성 고주파 신경근 응고술의 임상 연구

김천숙,배재영,배덕구,강규식,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Dorsal root ganglion(DRG) block by the local anesthetics and steroids which has done classically in low back pain(LBP) patients with radiculopathy has high incidence of recurrence rate and side effects of steroids. Recently a new technique of pulsed radiofrequency thermocoagulation(P-RFTC) was introduced and substituted for it because of the benefits such as relatively low recurrence rate, low risk of nerve injury and comfort during the procedure. We experienced 15 patients who had LBP with radiculopathy and no or little response to epidural steroid injection. When we performed DR ganglionotomy by P- RFTC under the C-arm guide in these patients, we tried to approach the exact DR ganglion using tow cannulas - the one for obtaining patient's subjective symptoms and injection of contrast dye, the other for making a RF lesioning after identifying the impedance of sensory and motor stimulation. In conclusion, DR ganglionotomy by P- RFTC using two cannulas in LBP patients is an easy and safe procedure with satisfactory results.

두개저 골절 환자의 임상적 고찰

김한식,목진호,이규춘,이영배 동국대학교 경주대학 1997 東國論集 Vol.16 No.2

저자들은 최근 2년간 본원 신경외과에 입원 치료 받았던 두부외상 환자 중 자료 분석이 가능했던 119례의 두 개저부 골절 환자를 대상으로 임상 분석하여 다음과 같은 결론을 얻었다. 두부외상후 두개저 골절의 발생 빈도는 34%로 남녀 발생비는 5 : 1이었고, 활동기 연령인 20∼59세가 70.6%를 차지 하였다. 원인으로는 교통사고가 56.3%로 가장 많고 추락, 산재, 낙상, 구타 순이었으며, 내원당시 환자상태는 경증뇌손상(GCS 13-15)이 64.7%, 중증 뇌손상(3∼8) 21.8%, 중등도 뇌손상(9∼12) 13.5% 순이었고 예후도 GCS가 높을수록 양호하였다. 임상소견은 뇌척수액 비루(43.7%)가 가장 흔하고 비루(31.9%), 안와부 반상출혈(31.1%), 기뇌증(26.1%), 청각소실(18.5%)등이었다. 뇌척수액루의 지속 기간은 87.7%가 7일 이내였고 보존적 치료로 93.9%가 해결되었다. 2∼4주 지속된 경우는 요추천자 배액술, 4주 이상된 경우는 수술을 시행하였다. 뇌신경 손상은 안면신경마비가 31.7%로 가장 높았고 발현 시기는 지연성 마비가 69.2%, 조기마비가 30.8%였다. 뇌막염의 발생 빈도는 5.9%로 모두 뇌척수액루가 1주 이상 지속된 경우였고, 항생제 투여군과 비투여군의 뇌막염 발생율은 각각 6.1%와 4.8%로 항생제가 감염율을 낮추지는 못했다. 119 consecutive cases with basal skull fractures out of 343 head injuried patients who were treated in Pohang Hospital from July 1995 to July 1997 were analysed. The authors reviewed the clinical features, radiologic findings, complications and outcomes. Most of the patients(70.6%) were between 20 and 59 years old. The basal skull fractures were more common in men than women-the ratio being 5 : 1. The cause of BSF were traffic accident(56.3%), fall down, work related, silp down, and assults in decreasing order of frequency. The outcome of treatment wee related to initial GCS(Glasgow coma scale) of patients. The severity of head injury were mild(GCS13-15)-64.7%, Moderate(GCS9-12)-13.5%, and severe(GCS3-8)-21.8%, The most common feature of BSF were rhinorrhea(43.7%), otorrhea(31.3%), raccoon's eye(31.1%), pneumocephalus(26.1%), hearing disturbance(18.5%). Most of CSF leakage(86.7%) were noted within 24hours after injury and most of leakage(93.9%) were ceased by conservative management within 2 weeks, but one case that did not respond to conservative and lumbar drainage required operative repair. The facial nerve(31.7%) was the most frequently involved cranial nerve followed by vestibulocochlear and optic nerve. The onset of facial palsies were immediate in 30.8% and delayed 69.2%. The incidence of meningitis was 5.9% and the prophylactic antibiotics had no beneficial effect in reducing the infection rate.

四肢의 Scar Revision에 있어 Modified Millard's Trick의 利用

金勳男,崔性玔,李斗炯,李圭源,皇甫宗演 大韓成形外科學會 1976 Archives of Plastic Surgery Vol.3 No.1

No matter how various methods may be tried, for scar repair of extremities, the results were not so acceptable unfortunately. Of these procedures, Millard's trick (The Double-Breasted Vest Principle) is the one of most popular methods and which has been loved by many surgeons, esp, plastic surgeons, up to date. However, even this method couldn't satisfied us, because of undesirable disadvantages, and our new repair method, entitle "Modified Millard's Trick Method" was designed with supplement of disadvantages of Millard's Tric in mind and has been used in attempt to prevent recurrence of the usual spread. This approach is advocated for scars in area where stretch-ing is usual or where a careful regular repair has failed to prevent it. If there is any depression associated with the scar, this is corrected simultaneously by advancing both skin flaps in opposite direction. We have tired this new method for 1- cases of patients, esp. for relatively wide linear scar (over 5cm) on extremities.

중추성 요붕증이 동반된 랑게르한스 세포 조직구증 1예

김진호,문준성,문선중,이지은,최재원,은미정,천경아,조인호,윤지성,원규장,이경희 신덕섭,이형우 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Central diabetes insipidus (DI) is a syndrome characterized by thirst, polydipsia and polyuria. Langerhans cell histiocytosis is one of the etiologies of DI. Recently we experienced a central DI associated with Langerhans cell histiocytosis. The 44 years old female patient complained right hip pain polydipsia and polyuria. We carried out water deprivation test. After vasopressin injection, urine osmotic pressure was increased form 109mOsmol/Kg to 327mOsmol/Kg (300%). Brain MRI showed a thickened pituitary stalk and at hot bone CT.CT guided biopsy revealed abnormal histiocytes proliferation and abundant lymphocytes, The final diagnosis was central DI associated with systemic Langerhans cell histiocytosis invading hip bone, L-spine and pituitary stalk. Desmopressin and etoposide chemotherapy were performed to the patient.

配當支給政策變更이 株價에 미치는 影響

金暎圭,禹春埴 成均館大學校 韓國産業硏究所 1988 韓國經濟 Vol.16 No.-

노년의 대퇴골 원위부 골절 시 동시에 시행한 전슬관절 성형술 및 금속판 내고정술 : 8예 보고 Report of Eight Cases

김동헌,장병춘,신규철,양준호 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

Supracondylar fracture of the femur can be treated by a wide variety of methods. Although satisfactory results have been achieved with either open and closed treatment, less certain results are obtained for the elderly who have pre-existing osteoarthritis and osteoporosis. Particularly, elderly patients who have preexisting osteoarthritis are at increased risk of posttraumatic arthritis, stiff knee, persistent pain. Primary total knee arthroplasty(TKA) might obviate many of these potential problems and help to return the high-risk patient to an ambulatory functional status immediately. There are few reports about this study. The purpose of this study is to evaluate the results treated by simultaneous internal fixation and TKA for the supracondylar fracture in the elderly who have osteoarthritis of the knee joint. From 1994 to 1998, eight primary TKAs using posterior cruciate sparing PFC knee(Press Fit Condylar, Johnson & Johnson, Raynham, U.S.A) were performed after internal fixation for the supracondylar fracture of the femur with Judet plate or condylar buttress plate by conventional means. Patella was not resurfaced in all knees. According to the M ller classification of the supracondylar fracture of the femur 5 fractures were type A, 2 in type B, 1 in type C. Five patients were female, 3 patients were male. The ages ranged from 66 to 81, with an average of 74 years. Patients were followed for at least 1 year(average 3 years). The mean interval between the injury and operation was 2 weeks(range, 1 week to 4 weeks). Active knee joint exercise was encouraged in a hinge brace under the postoperative pain control. Partial weight bearing was permitted at the postoperative 4 to 6 weeks using crutches. Full weight bearing was allowed after union of the fracture. Fractures were united in all patients and the average duration of bony union was 16 weeks. The average amount of flexion and average flexion contracture for the all patients at the most recent follow-up were 96 degrees (range, 45 to 120 degrees) and 7 degrees (range, zero to 20 degrees), respectively. Using the knee rating score advocated by the American Knee Society, the average postoperative score was 87 for pain and 80 for function. We concluded that simultaneous internal fixation and TKA for supracondylar fracture of the femur in elderly patients who have advanced knee osteoarthritis may provide satisfactory pain relief and function with acceptable morbidity.

팔로3징의 외과적 치료

천종록,전상훈,장봉현,이종태,김규태 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 비교적 드물게 보는 선천성 심질환중의 하나인 팔로3징에 대한 본원에서의 진단 및 치료 경험을 임상적으로 관찰하여 보고함으로써 향후 이 질환의 개심술 성적을 향상시키는데 기여하고자 하였다. 대상 및 방법 : 경북대학교병원 흉부외과에서 1980년 3월부터 1997년 2월 사이에 개심술을 받았던 환자들 중에서 심도자검사 및 수술소견에 의해 팔로3징으로 진단되었던 8례를 대상으로 술전증상과 진찰소견, 술전의 심초음파검사, 심도자검사 및 심혈관조영술의 소견들을 검토하였고, 수술소견으로는 폐동맥협착과 심방중격결손의 해부학적 형태, 체외순환시간과 대동맥차단시간, 수술방법, 술후 합병증 및 수술사망률 등을 조사하였다. 그리고 평균 4.8년에 걸친 술후 추적관찰을 하였다. 결과 : 술전 진단에 있어서는 2례에서 오진되어 있었고, 술후 조기의 병원사망례는 없었으나 1례에서 류마치스성으로 추정되는 다발성 심장판막질환으로 8년후 인공판막치환술을 받았는데 패혈증으로 사망하였다. 나머지 환자들은 모두 양호한 경과를 취하였다. 결론 : 이 질환의 술전 진단에 있어서 과거에는 상당한 오진이 있었음을 알 수 있었고, 술전 증상이 심한 환자가 많았던 사실을 감안하면 개심술 성적과 술후 경과는 양호한 편이었다. Eight parients with trilogy of Fallot, characterized by the combination of pulmonary stenosism, atrial septal defect(ASD) and Rt-to-Lt shunt in the atrial level in the presence of an intact ventricular septum, underwent surgical correction between March 1980 and February 1997. Four patients were male and four were female. Their ages ranged from 2 months to 20 years with a mean age of 12.1 years. Cardiac catheterization and angiocardiogram were performed in all patients and 2D-Echocardiographic studies were obtained in 4 patients before operation. The preoperative diagnoses were tetralogy of Fallot(TOF) + ASD in 2 cases, trilogy of Fallot in 6 cases had combined pulmonary stenosis. The atrial septal defect was closed by primary suture in 6 cases and patch closure was done in 2 cases. The pulmonary stenosis was correctied by valvotomy in 2 cases, valvotomy + infundibulectomy in 2 cases, valvotomy + infundibulectomy + right venr tricular outflow tract reconstruction in one case, valvotomy + infundibulectomy + transannular patching in 3 cases. No operative death resulted, but one patient expired after undergoing mitral valve replacement and tricuspid annuloplasty for mitral insufficiency, tricuspid insufficiency and pulmonary valve insufficency 8 years later. All surviving patients have remained in good condition.

수술실 오염도감소를 위한 수술실공조시스템에 대한 연구

김천숙,박은정,강규식,김지은,안기량,권진형,유시현,주영철,권순정 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Background: The OR(operating room) should provide an optimum environment that is safe for the patient and the working personnel. The air ventilation system of OR has been studied to decrease the contamination of air. We investigated the flow and contamination of the air in OR at our hospital. Method: Cultures in OR were made and the number of bacteria and fungi were calculated. A two-dimensional model for the cross-section of an operation room is developed for the CFD (computational fluid dynamics) analysis. The characteristics of air flow in the empty operation room and in the occupied operation room are calculated by using a CFD program. Results: The current air ventilation system of our hospital does not deliver the clean air to the operating site efficiently in occupied OR. Conclusions: We suggested a new location of air ventilation system which improves air venting with little increase of the cost of equipment.