2000년 제27회 시드니 올림픽 유도경기 대비: 세계 여자 우수선수들의 개인별 국제경기 기술 특성에 관한 연구

김의환,박순진,김관현,김도준,안병근,정훈,김미정 용인대학교 무도연구소 2000 武道硏究所誌 Vol.11 No.1

The purpose of this study was to analyze the competition techniques traits and of international contest levels each category individual scoring - losing techniques of world elite judokas who. were awarded in the international judo tournaments (I,J.T.) (part 1: ∼O.G'%, part 2 :from O.G'% to July ,2000), and who are expected to participate in the 27th Olympic Games(O.G.) Sydney 2000 to prepare the 27th O.G, which will be held from 16. to 22 September, 2000 at Exhibition Center, Darling Harbour, in Sydney, Australia. The records of the results and contents of competition were obtained out of 97 for women I.J,T., world elite judokas. To decide individual contest levels, groups were devided into 3(A,B,C)groups and points were graded by 3 ways. The I.J.T. that were devided into 3 groups are shown in the table 1.

하악 과두 과형성증에 관한 방사선학적 연구

김영진,최의환,김재덕,김진수 大韓口腔顎顔面 放射線學會 1995 Imaging Science in Dentistry Vol.25 No.2

Condylar hyperplasia is a self-limiting condition characterized by a slowly progressing, enlargement of the mandible that results in facial asymmetry and a crossbite malocclusion. The facial asymmetry, open bite or crossbite, and radiographic evidence of an enlarged condyle confirm the diagnosis of condylar hyperplasia. The etiology of the condition is unknown. This condition usually first becomes apparent during the second decade of life, when one condyle continues to grow while the other is no longer active. Radiographically, the condyle may appear enlarged or the neck of the condyle may be elongated or both may occur, Sometimes, however, no radiographically demonstrable condylar abnormality will be noted. Surgical correction with subcondylar osteotomy is the treatment of choice. We have observed two cases of condylar hyperplasia occurred in the mandibular condyle of 24-year-old and 35-year-old women. We obtained that two cases were shown the followed results; 1. Clinically, both cases was unilaterally developed on C/C area, with temporomandibular disorders and pain, facial asymmetry and malocclusion. 2. Radiographically, hyperplastic mass confined to the condyle. 3. Histopathologically, these cases shown increased hypertrophic region in parts, and lamellated bone with irregular trabeculae.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

유도 '되치기 본'의 개선 방안에 관한 연구

김의환,김도준,김규수,김관현,김종달,최종삼,조용철,박순진,윤익선,안병근,정 훈,김미정,한성철 龍仁大學校 武道硏究所 1999 武道硏究所誌 Vol.10 No.1

The purpose of this study was to reform practically a Korean Judo's Doechigi-Bon(Forms of Counterattack, judo's Gaeshi no Kata, Judo's Uradori no Kata, Judo's Gonosen no Kata) that was established in 1955 Korea, according to changing of techniques by Judo's modernization, in order to have Judo's carefulness and systematic diffusion. Reform procedure of Judo's Doechigi-Bon was 1st stage, Questionnaire survey 303 judokas, 2nd stage, Technical seminar by judo experts(12 judo professor) 4 times, 3rd stage, wording report for reform, 4rd stage, Discussion and judgement of Teaching and Judgement commission of Korean judo Association(KJA), 5th stage, Public hearing for reform in KJA, 6th stage, Report and decision of board of directors in KJA, 7th stage, public publication of Judo News(No.53) in KJA. Basic principle of reform of Judo's Doechigi-Bon were as table 1. Table 1. Basic principle of reform of Judo's Doechigi-Bon ------------------------------------------------------------------------------- Items Reformed Key Points of Judo's Doechigi-Bon ------------------------------------------------------------------------------- 1. Structure 1) Grand classification : Classified by 3 parts(1,2,3Gyo) 2)Medium classification : Te waza, Goshi waza, Ashi waza devided per each part(Gyo) 3)Sub-classification : Classified five techniques per each part(Gyo) 2. Contents 1) Selected established techniques as possible 2) Considered rationalty and overlapping of counterattack techniques 3. Decision of Conterattack techniques 1) Refered to results of Basic Questionnaire survey 2) Priority to decisions of Judo expert technical seminar -------------------------------------------------------------------------------- Reformed Korean Judo's Doechigi-Bon(Forms of Counterattack techniques-KJA, 1999) are as follows: 1. Gyo; ① Uki otoshi -> Uchi mata ② Harai goshi -> Harai goshi gaeshi ③ O soto gari -> O soto gake ④ Ko uchi gari -> Sasae tsurikomi ashi ⑤ O uchi gari -> Ko soto gari 2. Gyo; ① Ippon seoi nage -> Okuri eri jime ② Tsuri domi goshi -> Uki waza ③ Okuri ashi harai -> Okuri ashi harai ④ Ko soto gari -> Tai otoshi ⑤ Hiza guruma -> Hiza guruma 3. Gyo; ① Kata guruma -> Sumi gaeshi ② Tai otoshi -> Ko soto gari ③ Hane goshi -> Harai tsurikomi ashi ④ Uchi mata -> Tai otoshi ⑤ Tomoe nage -> O uchi gari

국내 다기관에서 조사한 지역사회획득 메티실린내성 황색포도알균의 빈도와 임상적 특성

송진수,최평균,송경호,조재현,김성한,방지환,이창섭,박경화,박경운,신수,최희정,김의석,김동민,이미숙,박완범,김남중,오명돈,김의종,김홍빈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

목적 : 최근 전세계적으로 지역사회획득 메티실린내성 황색포도알균(community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA)의 보고가 증가하고 있다. 하지만, 우리나라에서는 CA-MRSA 감염증에 대한 증례보고만 있을 뿐 아직까지 체계적인 연구결과가 없는 실정이다. 저자들은 국내에서 CA-MRSA의 빈도, 감염증의 임상적 양상, 분리된 균주의 항균제내성 양상을 조사하였다. 재료 및 방법 : 2005년 1월부터 2005년 6월까지 7개 병원에서 MRSA가 분리된 환자의 명단을 파악한 후 의무기록지와 건강보험심사평가원의 자료를 검토하였다. 외래나 응급실에서 혹은 입원 후 72시간 이내에 균주가 분리되고 MRSA 획득과 관련된 위험인자가 없는 경우 CA-MRSA로 정의하였으며, 분리된 균주의 임상적 의미에 따라 원인병원체(pathogen), 집락화(colonizer), 미결정(undetermined)으로 분류하였다. Penicillin과 oxacillin을 제외하고 3개 이상의 다른 계열 항균제에 내성이면 다제내성으로 정의하였다. 결과 : 연구기간동안 총 3,251주의 황색포도알균이 분리되었으며, 이 중 MRSA는 1,900주(58.4%)였다. MRSA 가운데 CA-MRSA는 114주(6.0%) 였으며, 이들이 분리된 부위는 귀(62주), 비뇨기계(14주), 피부 및 연부조직(11주), 호흡기계(10주), 혈액(3주) 등이었다. CA-MRSA 균주 가운데 집락균은 22주, 원인병원체는 22주였으며, 나머지 균주에 대해서는 그 임상적 의미를 결정할 수 없었다. 항균제 감수성 검사를 시행한 73균주 중 47주(64.4%)는 다제내성이었다. CA-MRSA 감염증 22예 중 피부 및 연부조직 감염(9예)과 중이염/외이도염(9예)이 가장 흔하였다. 침습적 감염증(invasive infection)은 4명(원발성 균혈증 3예, 감염성 관절염 1예)에서 확인되었지만, CA-MRSA 감염증으로 사망한 환자는 없었다. 결론 : 병원내 감염증에서는 MRSA가 심각한 문제이지만, 아직까지 지역사회 감염증에서 CA-MRSA는 흔하지 않았다. Background : Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. In Korea, little is known about the epidemiology and clinical features of community-associated MRSA (CA-MRSA). Material and Methods : Clinical microbiology laboratory databases of 7 hospitals were reviewed to identify the patients from whom MRSA was isolated during the period of January to July 2005. Only one isolate per patient was enrolled. In order to identify the risk factors of MRSA acquisition, the medical records and the Health Insurance Review Agency databases were reviewed. CA-MRSA was defined as MRSA isolated from patient without established risk factors. We analyzed patient demographics, underlying medical conditions, characteristics of infection, and antimicrobial susceptibility profiles. Results : Of total 3,251 S. aureus isolates, 1900 (58.4%) were MRSAs. Of the MRSA isolates, 114 (6.0%) were CA-MRSA. Of 114 CA-MRSA isolates, 22 (19.3%) were colonizers, 22 (19.3%) were pathogens, and the clinical significance of remaining 70 (61.4%) could not be determined. Median age of the 22 patients with CA-MRSA disease was 47 years. Nine patients had skin and soft tissue infections, 9 ear infections, 3 bacteremia, 1 septic arthritis. Seven patients had underlying medical disease. None died of the CA-MRSA infections. Of the 73 isolates of CA-MRSA, 47 (64.4%) were resistant to more than 3 classes of antibiotics besides β-lactams. Conclusion : Although MRSA is highly prevalent among hospital-associated S. aureus infection, CA-MRSA infections are not common.

한국 · 대만 유도국가대표선수들의 한팔 업어치기 동작 시근 활성도 비교 분석

김의환(Eui-Hwan Kim),안병근(Byung-Keun Ahn),김성섭(Sung-Sup Kim),조준명(Joon-Myoung Cho),지준안(Chun-An Chi),진종현(Jong-Hyun Jin),김지태(Ji-Tae Kim) 한국생활환경학회 2011 한국생활환경학회지 Vol.18 No.2

The purpose of this study was to compare and analyze the electromyograpic activity between Korean and Taiwanese of Ippon-Seoinage (one-armed shoulder throw) as Tokuinage (favorite and major technique) in Judo. The subject (Tori, attacker), who was 4 Korean and Taiwanese representative judoists from 2007 to 2009 years, respectively, Uke (defender) was a Judo-doll made by Kim, Eui-hwan etc. (2007), whole body of judo-doll was fixed, upper body was flexible 35 degree forward and backward, lower was 15 degree, was used to muscles activities measured by surface-electrode & electromyography. Subject performed 5 successful trials respectively, with parter (Uke) was resistance (R-0%) of judo-doll. Muscle activities were obtained from the electromyography analysis. Muscle activities in all phase, Taiwanese were lower than Korean, right Bicep, Trapezius, Tibialis muscles in Kuzushi phase, right Bicep, right Trapezius, left Rectus abdominus in Tsukuri and Kake phase, different between Taiwanese and Korean were signify (p < .5).

7개 대학 병원에서 조사한 지역사회 폐렴의 원인균

정문현,김성민,강문원,최희정,정희진,이경원,한성우,송재훈,신형식,김의종,최강원,김민자,박승철,배현주,정윤섭,김준명,백경란,신완식,이규만,김양리 대한감염학회 1997 감염 Vol.29 No.5

목 적 : 폐렴은 많이 발생하면서 사망률이 크게 줄지 않는 질환이며, 이를 적절히 치료하기 위해서는 원인균의 상대적 빈도, 기저 질환에 따른 변화, 항균제 내성률, 사망에 관련된 인자들을 알아야 한다. 원인균의 빈도는 지역마다 차이가 있고 국내에서는 항균제 내성률이 높아 지역사회에서 발생한 폐렴을 치료하기 위한 경험적 항균제 선택에 도움이 되기 위해 서울 소재 6개 대학 병원과 천안의 1개 대학 병원이 참여하여 위의 사항들에 대해 조사를 하였다. 방 법 : 1995년에 내과에 입원했던 16세 이상 환자를 대상으로 했다. 퇴원 진단명이 폐렴 또는 폐결핵인 병록지을 찾았고, 이중에서 병원 감염을 제외하였다. 특이도를 높이기 위해, 이들 중에서 호흡기 증상이 있고 발열이나 저체온이 있으면서 흉부 X-선에서 이상 음영이 있는 환자만을 대상으로 했다. 폐결핵은 위의 기준에 입원 초기에 항균제 치료를 하고 입원 7일 이후에야 항결핵제가 투여된 경우만을 폐렴의 원인균으로 하였다. 혈액 배양에서 양성, 객담에서 항상균이나 M. tuberculosis가 증명된 경우, 혈청학적으로 항체가가 4배 이상 증가된 경우, 조직에서 원인균이 진단된 경우는 확정(definitive) 원인균으로 하였고, 객담에서 배양된 균이 그람 도말과 일치할때, 항결액제에 대한 반응으로 진단한 폐결핵, 단일 항체가 양성이고 이에 대해 항균제를 사용했을 때는 가능(probable) 원인균으로 정의하였다. 다세균 감염균은 각각 다 른 원인균으로 처리하였다. 임상 조사와 함께 임상병리과에서 S. pneumoniae, H. influenzae, M. catarrhalis, mycoplasma, 항상균에 대해 검사 의뢰 건수, 배양 양성수, 항균제 감수성 결과를 조사하였다. 결 과 : 폐렴의 증례 정의에 부합하지 않은 135명과 폐결핵의 정의에 해당하지 않는 230명을 제외하고 남은 246명의 평균 나이는 58.2세이고 남성이 142명(58.2%) 이었고, 71%의 환자에서 기저 질환이 있었다. 진단 방법의 시행 횟수는 혈액 배양 77.6%, 혈청 검사 18.3%, 기관지경 검사는 4.1%였고, 세균의 항원 검사를 한 예는 없었다. 원인균이 밝혀진 예는 77명(31.3%)이었다. 다세균 감염이 4명에서 있었고, 원인균의 상대적 빈도는 결핵 20명(확정 17, 가능 3: 6개 병원 자료), 폐렴구균 18(확정8 가능 10)명과 폐렴구균이 아닌 Streptococcus 3명 (모두 확정), H. influenzae 11명(모두 가능), 그람음성간균 11명(확정 7, 가능 4) (K. pneumoniae 8건), Mycoplasma 5명(확정 1, 가능 4), S. aureus 4명(확정 2, 가능 2), mucormycosis 1명(확정)이었다. 평균 입원 기간은 19일이고, 중환자실 입원률과 인공 호흡기 사용율은 각각 18%와 9.3%였다. 사망률은 13.8%였고 사망까지 평균 기간은 14.6일 이었다. 다변량 분석에서 사망을 예측할 수 있는 인자는 저체온과 빈호흡이었다. 임상병리과에서 배양되었던 모든 폐렴구균의 Penicillin 내성률은 서울 3개 병원에서 82-88%, 천안에서 72%였다. 폐렴 환자의 혈액에서 배양된 7주는 모두 Penicillin에 감수성이 있었다. K. pneumoniae 8주 모두 cefotaxime과 gentamicin에 감수성을 보였다. 결 론 : 후향적 조사이고 병원마다 원인균 진단에 차이가 있지만, 원인이 밝혀진 경우에는 결핵과 폐렴균이 흔하였고, 무균 부위에서 배양된 폐렴구균의 항균제 내성률은 낮았다. 원인이 밝혀지지 않은 경우가 많고, 혈청검사로 진단되는 원인균이 드물며, 분리균주가 적어 항균제 내성 정도를 추정하기 어려워, 이를 밝히기 위한 전향적 조사가 필요하다. Background : Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity, but its management is still challenging. The limitation of diagnostic methods to identify etiologic agents rapidly make it necessary to use empiric antibiotics in almost all patients, and furthermore the discovery of new respiratory pathogens and the emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric regimen. To clarify the factors necessary for the optimal choice of empirical antibiotics, such as the frequency of etiologic agents, the attributable rates to death and antimicrobial resistance rates in the community, six university hospitals in Seoul and one university hospital in Cheonan were participating in this study. Methods : medical records of adults (>15 years of age) hospitalized for CAP or pulmonary tuberculosis between April 1995 and March 1996, were reviewed. Patients who satisfied all of the following criteria were included in the study: (1) fever or hypothermia; (2) respiratory symptoms; and (3) pulmonary infiltrates on chest roentgenogram. To exclude cases of pulmonary tuberculosis whose roentgenographic features were so typical that it could be easily differentiated from conventional pneumonia, two additional criteria were required for inclusion: antibiotic treatment during the first week of hospital admission and initiation of anti-tuberculosis medications thereafter. Organisms isolated from sterile body sites, acid-fast bacilli or Mycobacterium tuberculosis isolated from sputum, pathogens diagnosed by a 4-fold rising titer of antibodies to “atypical”pathogens, or pathogens revealed by histopathology were defined as definitive cause of pneumonia; isolates from sputum withcompatible Gram stain, pathogens diagnosed by a single diagnostic titer plus use of a specific antimicrobial agent, or tuberculosis diagnosed by clinucal response to anti- tuberculosis medications were considered probable cause of pneumonia. The records of the clinical microbiology were reviewed for isolates of S. pneumoniae, H. influenzae, M. catarrhalis, Mycobacterium or acid-fast bacilli, and Mycoplasma. Then the frequency of these agents, antimicrobial resistance rates of resiratory pathogens from all body sites, and their clinical significance were evaluated. Results: After excluding 365 patients (230 with pulmonary tuberculosis and 135 with CAP) who were screened for inclusion but did not meet the inclusion criteria,246 persons were enrolled in this study. Their mean age was 58.2 years old with slight male predominance (58.2%), and 171(71%) patients had underlying illnesses. Blood cultures were performed on 191 (77.6%) patients and serologic tests on 44(18.3%) patients. The etiologic agents were identified in 31.3%, and the list of individual agents, in decreasing order, was pulmonary tuberculosis (17 definite and 3 probable: data of six hospitals), S. pneumoniae (8 definite and 10 probable), non-pneumococci (3 definite), aerobic gram-negative bacilli (7 definite and 4 probable), Haemophilus spp. (11 probable), mycoplasma (1 definite and 4 probable), polymicrobial infections (2 definite and 2 probable: E. coli and S. agalactiae, M. tuberculosis and S. aureus, S. pneumoniae and H. influenzae and A. baumannii and K. pneumonias), S. aureus (2 definite and 2 probable) , and mucormycosis (1 definite). Among gram-negative bacilli, K. pneumoniae was the most common agent (8isolates). therates of admission to the intensive care unitand of using assisted ventilation were 18% and 9.3%, respectively. The mortality was 13.8% and logistic regression analysis showed that hypothermia and tachypnea were associated with death. Hospital stay averaged 19 days. Susceptible rates of S. pneumoniae isolated from all body sites to penicillin ranged from 8% to 28% but seven isolated from blood of patients with pneumonia were susceptible to penicillin. Also all 8 isolated of k> pneumoniae from patients with pneumonia were susceptible to cefotaxime and gentamicin. Conclusion: In Korea, in addition to S. pneumoniae, M. tuberculosis is an important agent causing community-acquired pneumonia. The low incidence of etiologic diagnosis is probably related to infrequent requesting of test "atypical" pathogens and does not represent the true incidence of infections by "atypical" pathogens, which well be answered by a prospective study. The antimicrobial resistance rates of major respiratory pathogens from sterile body sites are low, however, because of a small number of the isolates this result needs confirmation by a nationwide surveillance of antimicrobial resistance.

자기장 저속 냉동보관법을 이용한 쥐 치아 치주인대세포의 활성도 검사

안현정,김의성,김진,김덕원,김기열,이찬영,이승종 大韓齒科保存學會 2008 Restorative Dentistry & Endodontics Vol.33 No.4

본 연구의 목적은 흰쥐 상악 대구치를 발거하여 자기장 저속 냉동보관법을 이용하여 냉동 시 치주인대세포의 활성도 및 세포 사멸도를 MTT검색법과 TUNEL검사를 이용하여 측정하고자 하였다. 4주령의 암컷 Sprague-Dawley계 된 쥐의 상악 좌우 제1,2대 구치를 발거하여 각군 당 12개의 쥐 치아를MTT검색에 이용하였고 6개의 치아를 TUNEL 검사에 이용하였다. 실험군은 5개군으로 대조군은 즉시 발치군이며 4℃냉장고에서 1주일간 보관한 냉장군, 발치 후 동해방지제 처리과정을 거쳐 -196℃의 액화질소에 넣어 급속 냉동한 액화질소군, 21.7 ㎃, 60 ㎐, 1 G의 자기장을 이용하여 -0.3℃/min 의 속도로 -20℃까지 냉동 후 -196℃로 급속 냉동한 자기장군, -0.3℃/min의 속도로 -20℃까지 냉동 후 -196℃에 급속 냉동한 저속 냉동군으로 나누었다. 보존액은 F medium을 사용했으며 동해방지제로 10% dimethyl sulfoxide (DMSO)를 사용하였다. 치근면을 단위면적으로 표준화하기 위해 MTT측정값을 Eosin 염색 후 530 ㎜에서 측정한 흡광도 값으로 나누었다. TUNEL 검사 시 각 조직슬라이드에서 400배 크기의 현미경 시야에서 임의로 세 부분을 지정하여 정상 세포수와 양성 세포수를 세어 그 비율을 계산하여 각 실험군 당 평균치를 구하였다. 통계 분석을 위해 one way ANOVA를 시행하였으며 사후검정으로 Scheffe와 Tukey HSD방법을 썼으며 결과는 다음과 같다. MTT검색에 의한 흡광도를 Eosin염색 후 측정한 흡광도로 나눈 값에서는 자기장군은 즉시 발치군보다 낮은 세포활성을 보였고 (p < 0.05) 액화질소군, 저속 냉동군과는 통계적으로 유의성 있는 차이를 보이지 않았다. 그러나 자기장군은 액화질소군, 저속 냉동군과 함께 냉장군보다는 높은 세포 활성도를 보였다 (p<0.05).TUNEL검사 결과도 자기장군은 즉시 발치군보다 치주인대의 세포사멸도가 높았으나 (p < 0.05) 저속 냉동군과 액화 질소군과는 통계적으로 유의한 차이를 보이지 않았다. 자기장군은 냉장군보다 세포사멸도가 낮았으며 냉장군은 모든 군 중에서 세포 사멸도가 가장 높았다 (p<0.05). The purpose of this study was to evaluate the viability of periodontal ligament cell in rat teeth using slow cryopreservation method with magnetic field through MTT assay and TUNEL test. For each group, 12 teeth of 4 weeks old white female Sprague-Dawley rat were used for MTT assay, and 6 teeth in TUNEL test. The Maxillary left and right, first and second molars were extracted as atraumatically as possible under tiletamine anesthesia. The experimental groups were groupl (immediately extraction), group 2 (cold preservation at 4℃ for 1 week), group 3 (rapid Cryopreservation in liquid nitrogen), group 4 (slow cryopreservation with magnetic field of 1 G), and group 5 (slow cryopreservation). F medium was used as preservation medium and 10% DMSO as cryoprotectant. After preservation and thawing, the MTT assay and TUNEL test were processed. One way ANOVA and Scheffe method were performed at the 95 % level of confidence. The value of optical density obtained after MTT analysis was divided by the value of eosin staining for tissue volume standardization. In both MTT assay and TUNEL test, it had showed no significant difference among group 3,4, and 5. And group 3 had showed higher viability of periodontal ligament cell than group 2. From this study, slow cryopreservation method with magnetic field can be used as one of cryopreservation methods.

14세 여환에서 쇄골에 발생한 동맥류성 골 낭종 : 증례보고

김동수,김용민,최의성,손현철,박경진,조병기,홍경호 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1

동맥류성 골낭종(aneurysmal bone cyst)은 Jaffe와 Lichtenstein(1942)에 의해 처음 기술된 이래 많은 증례가 보고되었다. 동맥류성 골낭종은 주로 장관 골의 골간단과 척추에서 발생한다. 병인은 정확히 밝혀지지 않았으나, 반응성 현상으로 생각되며, 원발성 또는 다른 병변과 동반될 수 있다. 쇄골 등 기타 골에서 발생하는 경우는 매우 드물다. 저자들은 우측 쇄골에서 동맥류성 골낭종 1예를 경험하여 보고하는 바이다. 14세 여자환자가 우측 견갑부의 우연히 발견된 종괴를 주소로 내원하였다. 환자는 종괴에 대해 이학적 검사 및 혈액 검사상 측이한 소견을 보이지 않았다. 방사선 검사상, 쇄골 내측부에 골 용해성으로 팽윤된 병변이 관찰되었고, 동맥류성 골낭종, 단순 골낭종, 전이성 골종양 등의 의증 하에 절제술을 시행하였다. 절제된 종괴의 육안 소견상, 얇은피질 골로 쌓여 있으며, 노란색 액체로 차있는 4x5cm 종괴가 관찰되었고, 완전 절제술을 시행하였다. 광학현미경상, 혈액으로 차있는 다양한 크기의 낭성 구조가 보였고, 여러 개의 거대세포가 격막을 이루고 있었다. 조직학적 소견과 MRI소견, 임상 소견을 종합하였을 때, 쇄골에서 원발성으로 발생한 동맥류성 골낭종을 진단할 수 있었다. Many cases of aneurysmal bone cyst(ABC) have been reported since Jaffe and Lichtenstein(1942) first reported. Aneurysmal bone cyst mostly occurs in metaphysis of the long bones and vertebral column. The reason for this disease has not be clearly explained yet, but it is estimated as reactive change and can be accompanied with primary lesion or another lesion. It rarely occurs in clavicle or other bones. We report one case of ABC in right clavicle. 14-year-old female patient who accidentally found palpable mass on right shoulder visited hospital. We did not find any specifics regarding this patient's mass after physical exam and blood test. Radiologic exam showed a large expansile mass with osteolytic lesion, The differential diagnosis includes ABC, simple bone cyst, metastatic bone tumor, etc. Based on visual observation on excised 4×5 cm mass, it was covered by thin cortical bone and filled with yellow fluid, and complete excision was done. On histological examination, the mass consist of various size of cystic structures. and several giant cells comprised septae. Based on histological examination, MRI, clinical examination, we made a diagnosis that it was primary anuerysmal bone cyst in clavicle

Prednisolone과 Penicillamine이 사염화탄소 투여로 초래된 백서 간 섬유화에 미치는 영향에 관한 형태학적 연구

김창진,김의한,강상균 순천향대학교 1982 논문집 Vol.5 No.3

The various liver diseases result in fibrosis, which is irreversible and progressively replace normal hepatic parenchyma final]y bringing about hepatic failure. There are two theories for the pathogenesis of hepatic fibrosis. The one is that the fibrosis is resulted from condensation of pre-existing recitulin at the site of collapse of hepatic parenchymal cells, and the other is that the fibroblast is newly formed making collagen fibers and resulting in fibrosis, which is more widely accepted. In the past, the existence of fibroblast in the hepatic lobules was not recognized. But recently, using gold impregnation and ultrastructural studies by electron microscope, lipocytes, which contain many fat droplets in the cytoplasm reducing gold chloride, are recognized in the space of Disse. These cells are considered as precursors of fibroblasts. When they contain excessive vitamin A, which reduces gold chloride, in the cytoplasm, they are activated and transformed into fibroblasts resulting in collagen fiber formation. The present study is undertaken to investigate the role of lipocyte in early hepatic fibrosis and the effect of prednisolone and penicillamine on the early fibrosis induced by carbon tetrachloride and/or vitamin A, which is known to stimulate the lipocytes. By light and electron microscopic examinations following results were obtained. One hundred and twenty female rats, weighing about 200g, were divided into two major groups, control and experimental. The control group was subdivided into salad oil, vitamin A, prednisolone and penicillamine treated groups. The expermental group was subdivided into CCl₄, CCl₄ and vitamin A, CCl₄ and vitamin A with prednisolone, and CCl₄ and vitamin A with penicillamine treated groups. The liver tissue is fixed by perfusion method with mixture of 2% paraformaldehyde and 2% glutaraldehyde. For light microscopic examination the tissue was further fixed in 10% neutral formalin, and stained with hematoxylin-eosin, periodic acid-Schiff(PAS), Masson's trichrome, oil red-O and gold impregnation. For electron microscopic examination, the tissue is further fixed in 3% glutaraldehyde and 1% osmic acid, and stained with combination of uranyl acetate and lead citrate, and periodic acid methenamine silver(PAM), after routine Epon embedding and sectioning. By light and electron microscopic examinations following results were obtained. 1. The control group treated with salad oil only showed inactivated scant lipocytes with little perisinusoidal collagen fibers. 2. Vitamin A treatment induced activation of lipocytes resulting in collagen bundle formation near by or associated with cytoplasmic membrane and collagen fibrils in the cytoplasm. 3. Prednisolone treatment did not induce notable changes of lipocytes. 4. CC1₄ induced hepatic cell necrosis rapidly and accompanied inflammatory cells infiltration. The lipocytes were proliferated and activated at the area of inflammatory reaction and produced new collagen fibers. As the time passed. the collagen fibers decreased in the inflammatory reaction, and the lipocytes returned to resting form. 5. Combined treatment of vitamin A and CCl₄ showed accentuated effects on lipocytes. 6. Prednisolone treatment together with CCl₄, and vitamin A showed inhibition of lipocytic activity and depression of collagen fiber formation. 7. Penicillamine treatment together with CC1₄ and vitamin A showed no different effects. as those treated with CCl₄ and vitamin A. In conclusion, the perisinusoidal fibrosis seen in association with hepatic necrosis was induced by activation of lipocytes, and prednisolone inhibited activation of lipocytes resulting in the depression of early phase of fibrogenesis but penicillamine did not show any effect morphologically.