경간동맥화학색전술로 치료받은 간암환자의 생존율과 관련된 예후인자 분석

임정묵,이태원,박선미,윤세진,박길선,채희복,이헌영 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Transarterial Chemoembilization (TACE) has been shown to be effective in patients with unresectable hepatocellular carcinoma (HCC) and can be applicable to patients with resectable HCC who reject operation. There have been studies concerning prognostic factors in patients with (HCC) undergoing TACE but they reported diffenrent prognostic factors from each other. The aim of this study is to estimate the survival rates and to determine which prognostic factors contribute to long-term survival after TACE of HCC. Thirty eight patients with HCC who had been treated by TACE were analized retrospectively. TACE was accomplished by hepatic arterial infusion of a suspension of lipiodol and anticancer drugs (Adriamycin), either alone or followed by gelfoam embolization. Male to female ratio was 4.4:l. Mean survival time was 463 days. Maximum survival time was 1,683 days. The overall cumulative survival rates at the end of the first and second years were, respectively, 54% and 38%. According to univariate analysis (log-rand scale test), variables significantly associated with survival were: tumor type, hepatic vein thrombosis, portal vein thrombosis, lipiodol uptake pattern, remained enhancement after TACE, AST, ALT, height and tumor size. Multivariate analysis (Cox proportional hazard model) for the significant variables in a univariate analysis revealed that the AST level, hepatic vein thrombosis, remained enhancement after TACE were statistically significant independent prognostic factors. The criteria of known contraindication may still be applied for TACE treatment of HCC. Additionally we should select the good prognostic patients without hepatic vein thrombosis and try to normalize the AST level if abnormal level before undergoing TACE. Thereafter, intensive chemoembilization to minimize the remained tumor is required to improve survival rates.

백서의 말초 신경병증성 통증모델에서 역방향성 임펄스가 기계적 이질통에 미치는 영향

신진우 ( Jin Woo Shin ),함경돈 ( Kyung Don Hahm ),임중우 ( Joong Woo Leem ),박세훈 ( Sae Hun Park ),최윤 ( Yoon Choi ),정월선 ( Wol Seon Jung ),이청 ( Chung Lee ) 대한통증학회 2003 The Korean Journal of Pain Vol.16 No.1

Effects of Nefopam on Streptozotocin-Induced Diabetic Neuropathic Pain in Rats

( Jae Sik Nam ),( Yu Seon Cheong ),( Myong Hwan Karm ),( Ho Soo Ahn ),( Ji Hoon Sim ),( Jin Sun Kim ),( Seong Soo Choi ),( Jeong Gil Leem ) 대한통증학회 2014 The Korean Journal of Pain Vol.27 No.4

Background: Nefopam is a centrally acting non-opioid analgesic agent. Its analgesic properties may be related to the inhibitions of monoamine reuptake and the N-methyl-D-aspartate (NMDA) receptor. The antinociceptive effect of nefopam has been shown in animal models of acute and chronic pain and in humans. However, the effect of nefopam on diabetic neuropathic pain is unclear. Therefore, we investigated the preventive effect of nefopam on diabetic neuropathic pain induced by streptozotocin (STZ) in rats. Methods: Pretreatment with nefopam (30 mg/kg) was performed intraperitoneally 30 min prior to an intraperitoneal injection of STZ (60 mg/kg). Mechanical and cold allodynia were tested before, and 1 to 4 weeks after drug administration. Thermal hyperalgesia was also investigated. In addition, the transient receptor potential ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) expression levels in the dorsal root ganglion (DRG) were evaluated.Results: Pretreatment with nefopam significantly inhibited STZ-induced mechanical and cold allodynia, but not thermal hyperalgesia. The STZ injection increased TRPM8, but not TRPA1, expression levels in DRG neurons. Pretreatment with nefopam decreased STZ-induced TRPM8 expression levels in the DRG.Conclusions: These results demonstrate that a nefopam pretreatment has strong antiallodynic effects on STZ-induced diabetic rats, which may be associated with TRPM8 located in the DRG. (Korean J Pain 2014; 27: 326-333)

알코올성 간경변 환자에서 위대망 정맥류 출혈로 인한 자발성 혈복강 1 예

채희복,윤세진,박선미,성노현,배일헌,임정묵,장이찬,최기원,신종성,지정훈 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.3

Portal hypertension often leads to the development of several collateral vessels that shunt blood flow from the portal to the systemic circulation. The rupture of intra-abdominal varix is an unusual complication of portal hypertension that can lead to life-threatening hemoperitoneum of the patient is herrmdynamically unstable due to massive intra-abdominal bleeding, exploratory laparotomy should be performed on the patient. There are several reported cases of intra-abdominal variceal bleeding such as paraumbilical varix, the varix from the small intestine and proximal colon etc. Spontaneous hemoperitoneum caused by the rupture of gastroepiploic vein varix, however, has not been repzted in Korm, to the best of our knowledge. We wiU discuss a patient with portal hypnsion due to liver cirrhosis who pnmented with acute intra-abdominal bleeding. During the laparotomy, he was found to have a rupture of the gastnxpiploic vein. 'Ihe vessel was ligated, and the patient recovered uneventfully by operative variceal ligation. (Korean J Hepatol 2001;7:336-340)

Effects of Nefopam on Streptozotocin-Induced Diabetic Neuropathic Pain in Rats

Nam, Jae Sik,Cheong, Yu Seon,Karm, Myong Hwan,Ahn, Ho Soo,Sim, Ji Hoon,Kim, Jin Sun,Choi, Seong Soo,Leem, Jeong Gil The Korean Pain Society 2014 The Korean Journal of Pain Vol.27 No.4

Background: Nefopam is a centrally acting non-opioid analgesic agent. Its analgesic properties may be related to the inhibitions of monoamine reuptake and the N-methyl-D-aspartate (NMDA) receptor. The antinociceptive effect of nefopam has been shown in animal models of acute and chronic pain and in humans. However, the effect of nefopam on diabetic neuropathic pain is unclear. Therefore, we investigated the preventive effect of nefopam on diabetic neuropathic pain induced by streptozotocin (STZ) in rats. Methods: Pretreatment with nefopam (30 mg/kg) was performed intraperitoneally 30 min prior to an intraperitoneal injection of STZ (60 mg/kg). Mechanical and cold allodynia were tested before, and 1 to 4 weeks after drug administration. Thermal hyperalgesia was also investigated. In addition, the transient receptor potential ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) expression levels in the dorsal root ganglion (DRG) were evaluated. Results: Pretreatment with nefopam significantly inhibited STZ-induced mechanical and cold allodynia, but not thermal hyperalgesia. The STZ injection increased TRPM8, but not TRPA1, expression levels in DRG neurons. Pretreatment with nefopam decreased STZ-induced TRPM8 expression levels in the DRG. Conclusions: These results demonstrate that a nefopam pretreatment has strong antiallodynic effects on STZ-induced diabetic rats, which may be associated with TRPM8 located in the DRG.

Galanin이 흰쥐 결장운동에 미치는 영향

진영주 ( Young Joo Chin ),임정묵 ( Joung Muk Leem ),채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.3

Background/Aims: Galanin is distributed in enteric nerve terminals throughout the gastrointestinal tract. However, the effect of galanin on colonic motility in isolated colon is still unknown. Using isolated, vascularly perfused rat colon, we investigated the role of galanin on colonic motility, the difference in the effect of galanin between proximal and distal colon, and the innervation of the action of galanin on colonic motility (cholinergic or adrenergic input). Methods: An isolated rat colon was placed in temperature-controlled water bath and vascularly perfused with Krebs solution. After a controlled period, galanin was administered intraarterially and the intraluminal pressure was monitored via microtip catheter pressure transducers at the proximal and distal colon. After pretreatment of phentolamine, propranolol, hexamethonium or atropine, respectively, galanin was infused at a concentration of 240 pM and intraluminal pressure was monitored. The contractile response was expressed as % changes of motility indices over basal period. Results: Galanin significantly increased colonic motility (p<0.01). The contractile response was more potent at the distal colon but the difference was statistically insignificant (p>0.05). The stimulating effect was not inhibited by phentolamine, propranolol, hexamethonium but significantly inhibited by atropine. Conclusions: Galanin increases rat colonic motility and the action of galanin is influenced by cholinergic input. (Korean J Gastroenterol 2003;41:196-203)

과민성 장 증후군에서 장 점막 비만세포

최재홍 ( Jae Hong Choi ),나병규 ( Byung Kyu Nah ),임정묵 ( Jung Muk Leem ),배상석 ( Sang Seok Bae ),최기원 ( Ki Won Choi ),채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ),성노현 ( Ro Hyun Sung ) 대한소화기기능성질환·운동학회 2004 Journal of Neurogastroenterology and Motility (JNM Vol.10 No.1

목적: 과민성 장 증후군은 임상적으로 매우 흔한 질환이지만 아직까지 그 원인이나 기전이 명확하게 밝혀지지 못한 상황이다. 비만세포는 장관 신경과 평활근의 기능을 변화시키는 중요한 매개체를 가지며 장관 신경과 근육과도 상호작용을 하여 과민성 장 증후군의 병인에 작용할 수 있다고 생각한다. 이에 저자들은 비만세포가 과민성 대장 증후군 환자의 대장 점막에서 정상 및 염증성 질환 환자에 비해서 차이가 있는지 알아보고, 과민성 장 증후군의 아형에 따라서도 차이가 있는지를 알아보고자 하였다. 대상 및 방법: 대상 환자는 충북대학교 병원 내과에서 진료 받은 환자들 중 Rome II 진단 기준에 합당한 환자들을 대상으로 하였으며 과민성 장 증후군 환자는 16명, 정상 대조군 8명, 염증성 대조군은 5명이었다. 모든 환자는 대장내시경 검사를 시행하였고, 맹장, 상행, 하행 결장과 직장 부위에서 생검을 하였다. 비만세포는 트립타제에 대한 항체를 이용한 면역 염색법으로 관찰하였고, H&E 염색을 통하여 중성구, 림프구, 형질세포와 호산구의 수를 측정하여 차이를 비교하였다. 결과: 비만세포수는 하행 결장에서만 과민성 장 증후군(15.2±4.0)에서 정상 대조군(10.9±2.7)과 염증성 대조군(11.0±2.9)보다 유의하게( p=0.02) 높았으며, 다른 부위에서는 유의한 차이가 없었다. 비만세포를 제외하고는 과민성 장 증후군에서 다른 염증세포의 침윤이 증가해 있지는 않았다. 과민성 장 증후군의 증상의 유형에 따라서도 차이가 있어 맹장 부위에서의 비만세포수가 변비형(21.3±3.4)과 통증형(22.7±2.5)이 설사형(14.6±4.2)보다 유의하게 높게 나타났다( p<0.05). 결론: 과민성 장 증후군에서 다른 염증성 및 정상 대조군과 비교하여 하행 결장의 점막에서 비만세포의 수가 유의하게 높았고, 과민성 장 증후군의 증상별 아형에 따른 비교에서는 변비형과 통증형이 설사형 보다 맹장 부분에서 유의하게 높게 관찰되었다. 과민성 장 증후군에서 비만세포가 병인에 관여하며 증상의 아형별에 따라서 그 관여정도가 차이가 존재할수 있음을 시사한다. Backgr ound/Aims: Irritable bowel syndrome (IBS) is ubiquitous but the pathophysiology remains poorly established. There has been increasing interest in the role of mast cells (MC) as they release variable mediators and have receptors for neurotransmitters. The aim of this study was to determine whether MC were increased in the colonic mucosa of IBS patients compared to controls. Methods: Biopsy was done from the cecum, ascending colon, descending colon and rectum of 29 patients: 16 IBS, 8 normal, and 5 inflammatory controls. Tissue was stained immunohistochemically with a monoclonal antibody for human mast cell tryptase for MC, and H&E stain for other inflammatory cells. Results: MC count of IBS patients at the descending colon (15.2±4.0) was significantly higher than that of either normal controls (10.9±2.7) or inflammatory controls (11.0±2.9). In a group of patients with IBS, MC count at the cecum was significantly higher in the constipation-predominant subtype (21.3±3.4) and the pain-predominant subtype (22.7±2.5) than the diarrheapredominant subtype (14.7±4.2). Conclusions: Patients with IBS have higher MC count than controls, and MC count in constipation-predominant IBS patients was significantly higher than diarrhea-predominant IBS patients. These findings suggest that MC might play an important role in IBS. (Kor J Neur ogastr oenter ol Motil 2004;1:57-62)

수입 및 국내 다류제품중의 중금속 함량과 분포도에 관한 연구

최광식,장영미,오재호,이광수,임동길,구용의,이순호,이선화,김재이,김진숙,강금자 식품의약품안전청 1998 식품의약품안전청 연보 Vol.2 No.-

기호성식품인 다류제품에 함유된 새육 필수 금속원소들(Cr, Ni,Cu,Se,Zn)과 ㅐ로이 위해성 물질로 논란이 많은 Al 및 유해성 금속(Hg, Pb,Cd, As)들을 포함한 10종의 금속원소으 함량을 분석하엿다.생육 필수 금속원소들은 과량 섭취의 위험성과 Al의 겨우는 기본적인 함ㄹ야에 대한 데이터확보, 유해성 금속드르이 경우는 그 오염도를 확인하여 이를 통하 ㄴ다류제품의 안전성과 기준규격설정의 기초자룔르 제시하고자 하엿다. 각 다류제품별 비교분석에서 모든 다류 중 생육필수 금속원소들의 과량섭취 위험성은 낮았으며 유해성 긍속의 평균함량도 낮게 나타났다. 그러나 유금속의 최고 함량은 유자차에서 Pb이 7.2ppm(건고물기준, 애하 모든 농도는 건고물기준으로 표시)으로 나타났고 As웨 경우는 다시마차에서 3.gppm까자 검출되었다. 다류제품을 식품공전에 따라 4그룰 슥, 침출차,추굴차, 분말차, 과시차로 나누어 비교 분석한 결과는 침출차에서 Al, Zn,'Cu, Ni 둥좌 함량이 다른 차종에 비해 유의성 있게 높은 것으로 나타났다. 수입침출차와 국산침출차의 금속원소참량 비교결롸는 Al의 경우 국산제픔보다 수입제품페서 평균1.5배 높았으며 Cu도 약 2.6배 높게 나타났다. 실제 침출차(홍차,현미녹차,녹차)의 침출시간에 따른 Al의 유리량은 실온에서 90~95℃물로 3분간과 10분간 침출시 평균 20.2~62.7%유리되어 일일섭취량과 비교시 실제 섭취하는 양은 낮은 것으로 나타났다. In order to confirm the safety and offer the guideline of restriction on metal elements in tea products, the contents of Al, Cr, Ni, Cu, Zn, As, Se, Cd, Pb and Hg were measured witIL a ICP-IHASSand a mercury analyzer. It was estimated that tile average of the harmful metal contents(As, Pb, Cd,Hg) and the the essentiat metal elements(Cr, Ni, Cu, Zn, Se) were relativelf low. However, the maxi-raum content of lead(Pb) was up to T.2mg/kg drr· weight in a citron tea. In case of arsenic(As), it was3.gmg/11g dry wright in a tang tea. The contents cif alumiuiuin(Al) in a black tea and an unpolished rice& green tea were higher than other tea products. In a blaclt tea, it was detected that the average aBdthe maxieum of aluminium contents were 1253.9 and 4789.Smg/ltg dry weight respectively. When ablack tea, aB unpolished rice & green tea and a green tea were steeped in 90-95'c water(for 3 min. and10 min.) at room temperature,20.2-62.7% of Al centent was extracted.

Case Reports : Total Occlustion of Left Main Coronary Artery by Dilated Main Pulmonary Artery in a Patient with Severe Pulmonary Hypertension

Ju Yong Lee,Hyuck Moon Kwon,Bum Kee Hong,Hae Kyoon Kim,Ki Whan Kwon,Jae Young Kim,Kyo Jun Lee,Tae Soo Kang,Dong Soo Kim,Young Hak Shin,Jin Seon Leem,Hyun Seung Kim 대한내과학회 2001 The Korean Journal of Internal Medicine Vol.16 No.4

A 34-year-old woman was admitted to the hospital because of recently aggravated right heart failure without angina for 5 months. When she was 25 year sold, patch repair with Polytetrafluoroethylene (PTFE) was performed for the secondum type of atrial septa