비강 및 비인두에 발생한 도립유두종과 편평상피암종의 p53단백 및 세포증식능에 관한 연구

한주호,윤기중,이재규,신대균,박근호,조향정,문형배 圓光大學校 醫科學硏究所 1996 圓光醫科學 Vol.12 No.2

The inverted papilloma and squamous cell carcinoma are common neoplasia in the sinonasal cavity and nasopharynx, but the incidence of these tumors are very low and the study on the oncogenesis or biological activity of the tumor cells are not well known. This study was designed to evaluate the oncogenic roles of the p53 gene and the proliferative activity of the tumor cells in the inflammatory polyp, inverted papilloma and squamous cell carcinoma. The experiment was carried by the immunohistochemical stains about the p53 protein, PCNA and Ki-67, histochemical stain about the AgNORs. and flow cytometric analysis about the DNA ploidy using the formalin fixed paraffin embedded tissues. The frequency of the expression of p53 protein was 0%(0/16 cases) in the inflammatory polyps, 18.8% (3/16 cases) in the inverted papillomas, and 87.5%(14/16 cases) in the squamous cell carcinomas. The labelling index(%) of the PCNA and Ki-67 was 5.3% and 3.3% in the inflammatoy polyps, 29.6% and 25.2% in the inverted papillomas, and 51.9% and 36.8% in the squamous cell carcinoma. The expression of the PCNA and Ki-67 was distributed in the periphery of the tumor islands of the inverted papilloma and was distributed in the both of center and periphery of the tumor islands of the squamous cell carcinoma. The number of nuclear AgNORs was increased in the order of inflammatory polyps (0.96), inverted papillomas(1.34) and squamous cell carcinoma(2.09). The frequency of the DNA aneuploidy was 0%(0/16 cases) in the inflammatory polyps, 18.8%(3/16 cases) in the inverted papillomas. and 12.5%(2/16 cases) in the squamous cell carcinomas. Above results indicates that the changes of the p53 gene and proliferative activity of the tumor cells are involved on the oncogenesis and the biological activity of the inverted papilloma or squamous cell carcinoma in the nasopharynx and sinonasa cavity.

하악골 후방이동시 중안면부 연조직의 변화양상에 대한 임상통계학적 연구

한대희,김수남,민승기,김태성,성헌모 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalo-metrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1.There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2.There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3.The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4.The upper lip length was increased and moved posterior direction after mandibular setback surgery 5.The lower lip was moved posterior direction by posterior movement of the mandibular structure 6.Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

좌골부 욕창의 치료

박대환,한동길,안기영 대구효성가톨릭대학교 1996 연구논문집 Vol.53 No.2

Ischial ulcers are the most common of all pressure ulcers, probably because they directly overlie the points of maximum pressure on the sitting surface. Furthermore, they are among the most common secondary ulcers for the same reason. Also, ischial ulcers are frequently complicated by abnormal lesional bursae, by extension, fistula toward the perineum, urethra, or peritoneal cavity. Urethrograms or panendoscopy are necessary prior to surgery and must remove all irreversibly damaged tissue. Consequently any surgical plan for ischial ulcers must take into account the effects of bone removal on weight bearing and positioning, and must provide stable, durable soft tissue cover intelligently designed to be reliable in the event of a recurrence. From April 1990 to April 1993, we had reconstructed 15 cases of ischial ulcers. In 13 cases of primary ulcers, inferior gluteil thigh flip (7 case), transpositin flap(2 case), ischiectomy and direct closure (3 cases), gluteus maximus myocutaneous island flap(1 case) was done. In 2 cases of secondary ulcers, V-Y advancement flap of biceps femoris and semitendinosus and gracillis muscle flap were done each other.

유방암에서 bcl-2와 p53 표출에 관한 연구

김의한,김대중,강상균,양승하,홍기언 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.2

In order to observe the expression of bcl-2 and p53 protein in the 29 cases of invasive ductal carcinomas and to evaluate the correlationship between the two results, the author has carried out immunohistochemical staining with mononuclear antibodies against bcl-2 and p53. The results are obtained as follows: 1. bc1-2 showed positive reaction in normal duct, lobule and hyperplastic epithelium, and p53 showed no reaction in the same tissue. 2. In 15 cases of well differentiated type, the bc1-2 was positive in 14 cases (93%), and the p53 was positive only in 4 cases (26%). In 6 poorly differentiated type, the bcl-2 was positive in 2 cases (33%), and the p53 was positive in 3 cases (50%). The relationship between the bcl-2 and the p53 showed that in well differentiated type, bcl-2(+)/p53(-) expression was most commonly observed, while the bcl-2(-)/p53(+) expression was not seen in well differentiated type. 3. The size of tumor appeared to have no direct relationship to bcl-2 and p53 positive rate. 4. The expression of bcl-2 and p53 in intraductal carcinoma portion showed that when intraductal tumor component was positive, the invasive portion tumor cell was also positive. However the bcl-2 positive tumor cells in some intraductal component apeared to be negative in p53. Above findings showed that the bcl-2 protein was more frequently expressed in low grade lesion and the p53 protein was in high grade lesion. Also bcl-2 and p53 positive or negative findings showed different results in the same tumor cells.

내시경을 이용한 관골궁골절 정복술

박대환,이재욱,장경수,송철홍,한동길,안기영 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.1

Although the zygomatic arch can be employed as a key landmark to the accurate alignment of a displaced zygoma fracture, it has been traditionally avoided because of the need for a bicoronal incision. Exposure of the zygomatic arch by means of the conventional bicoronal incision has several possible disadvantages, including an increased risk of blood loss, alopecia, loss of sensation posterior to the incision, and traction palsy of the facial nerve. Endoscopic-assisted exposure of a zygomatic arch can largely obviate the disadvantages of a bicoronal incision and yield this site accessible to reduction and internal fixation in the routine treatment of displaced zygoma fractures. 9 cases of endoscope-assisted open reduction of zygomatic arch fracture and 3 cases of internal fixation of a moderately displaced zygoma fracture are presented. To accomplish this technique, a rigid 4 mm, 30 degree down-angled endoscope, trocar and cannula, endoscopic forehead lift instrument were used. The postoperative courses were satisfactory with few complications. The use of endoscope in the treatment of zygoma reduction provided an expanded field of vision, direct manipulation of lesions, minimal postoperative scar. In particular, exposure and fixation of the zygomatic arch were performed without the need for a bicoronal incision.

횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예

최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.

외경 0.25 ㎜ 동맥의 단단 및 단측문합법

전대우,정재홍,강진성,한기환 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.3

Microvascular surgery has rapidly developed in the last 30 years and vessels of 1.0 mm can be anastomosed easily with a patency rate over 90 percent and is widely used in clinical practice with remarkable success. To obtain more successful microvascular anastomosis in smaller vessels, the improvement in methods of microanastomosis, the development of microvascular instruments including the operating microscope along with microsutures, and anticoagulants are needed. These improvements made microvascular anastomoses of vessels that are less than 0.5mm in extemal diameter possible. Huang et al.? performed anastomoses of the vessels in rats with an external diameter of 0.2 mm using a high magnification operating microscope, specially designed microinstruments, and fine sutures, and achieved a patency rate of 76 percent in the second postoperative week. However, we tried to anastomose vessels with an external diameter of 0.25 mm with ordinary instruments and 11-0 nylon. Animal studies on 180 rats were carried out by doing end-to-end anastomoses and 180 end-to-side anastomoses. In the end-to-end and end-to-side anastomoses, each 180 rats were then divided into 3 groups each. Group A was the control group. Aspirin and persantin were given orally in group B. Ticlopidine hydrochloride was given orally in group C. The method of end-to=end anastomosis was as follows : A superficial epigastric artery as small as 0.25 mm in diameter was severed transversely and longitudinal incisions, the length of the arterial diameter, were made down opposite sides of each end. Each flared fragment of the proximal end is approximated with each distal end and sutured together by only two stitches. The method of end-to-side anastomosis was as follows. In the side of the femoral artery an elliptical hole was made the same length of the circumference of the superficial epigastric artery, then the superficial epigastric artery was incised in the same manner as the end-to-end anastomosis. The flared ends of the superficial epigastric artery were then inserted into the hole of the femoral artery and sutured by four stitches. Light microscopic and scanning electron microscopic observation was performed serially at 3 days, 2 weeks, 3 weeks after the microvascular anastomosis for studying change of vessel diameter and histopathological changes at the microvascular anastomotic sites. The results were as follows : 1. The patency rate for the end-to-end anastomoses in the third postoperative week was 25% in the control group(A), 35% in the aspirin-persantin group(B), and 40% in the ticlopidine group(C) ; in the end-to-side anastomoses, 45% in group A, 50% in group B, and 60% in group C. 2. In the patency rate, the ticlopidine group is slightly higher than the aspirin-persantin group and even higher than the control group (P<0.05) in the end-to-end and end-to-side anastomoses. However, the end-to side group is higher in all 3 groups than the end-to-end one (P<0.1). 3. The intimal regeneration in all arteries was completed at end of the third postoperative week in the end-to-end and end-to-side anastomoses. 4. Changes of the internal diameter in anastomosed vessels showed luminal narrowing in the vessels at the third postoperative day and still narrowing at the second and third postoperative week in the end-to-end anastomoses. However, initial postoperative widening continued into the third postoperative week in the end-to-side anastomoses. The authors got a high success rate of anastomoses of very small arteries approximately 0.25 mm in external diameter, by developing a method of using an ordinary microscope and instruments, 11-0 nylon suture, and the administration of ticlopidine hydrochloride which is a more powerful anticoagulant than aspirin-persatin.

항 Vancomycin 내성균성 항생물질을 생산하는 Streptomyces sp.AMLK-335의 배양조건

이기형,임대석,최경희,이경호,김창한,김정환 건국대학교 동물자원연구센터 2000 動物資源硏究誌 Vol.21 No.-

본 연구는 새로운 항 vancomycin 내성균성 항생물질을 개발하기 위하여 실시되었으며, 전국 각지의 토양 시료로부터 분리한 방선균 중 vancomycin 내성균주인 K-98 Enterococcus faecium 642, K-98 Enterococcus faecium 637 균주에 대하여 항생물질을 생산하는 분리균주 AMLK-335를 선정하여 이 균주의 항생물질 생산에 대한 최적 발효 조건을 검토한 결과, 탄소원 첨가로는 glycerol(0.5%), 질소원 첨가로는 yeast extract(0.5%)가 가장 효과적으로 항생물질 생산에 이용되었고, 비타민을 첨가에 따른 항생물질 생산성의 차이는 크게 나타나지 않았으나, calcium pantothenate 첨가시 항균활성이 비교적 높아졌으며, 금속이온의 첨가는 K+, Pb+, Ba²+, NA²+ , Ca²+를 첨가하였을 때는 항생물질의 생산성이 비교적 높아졌으며, 그중 Ca²+ 첨가구가 가장 생산성이 높았으며, Fe²+ , Hg+의 금속이온을 첨가하였을 때는 항생물질 생산성이 감소하였으며, CaCO₃첨가는 비첨가구보다 높은 항생물질 생산성을 보였으나, 첨가량에 따른 영향은 대체적으로 없었다. pH의 변화에 따른 생산성은 전반적으로 pH가 항생 물질 생산에 영향을 미치지 못하였으나, pH 4.5∼6.0 부근에서는 비교적 높은 항생물질 생산성을보였으며, 통기량에 따른 항생물질 생산성은 통기량이 많을수록 항생물질 생산이 좋았다. 한편 배양기간에 따라 항생물질 생산성을 조사한 결과, 5일째에 가장 높은 항생물질 생산성을 나타내었으며, pH의 변화는 배양 초기에 하강하였다가 점차 상승하는 경향을 보였다. This study was carried out for examining antibiotic productivity of the strain Streptomyces sp. AMLK-335 producing anti-VRE antibiotic. According to different condition, the strain was cultured for 4 days at 27℃ and determined cell growth, pH value and antibiotic productivity using disk diffusion method. In the experiment, the strain Streptomyces sp. AMLK-335 was examined various culture conditions which was added 8 carbon sources, 12 nitrogen sources, 8 vitamins and 11 metal ions in each time and controlled concentration of CaCO₃, initial pH and aeration. From the studies of conditions for antibiotic production, antibiotic productivity was the best to use 0.5% glycerol as carbon source and 0.5% yeast extract as nitrogen source. When several vitamins were added to medium, there was little difference in antibiotic productivity. But the addition of calcium pantothenate slightly increased antimicrobial activity. The addition of metal ion, such as K+, Pb+, Ba²+, NA²+ and Ca²+ slightly increased antibiotic productivity except Fe²+ and Hg+. The addition of CaCo₃showed higher than non-addition experiment in antibiotic production, but there wasn't generally influenced at addition concentration. According to pH change, antibiotic productivity was increased at pH 4.5∼6.0, and when there was a lot of aeration, antibiotic productivity was increased.

마우스 종양발생에서 Nitric Oxide의 역할에 관한 연구 Ⅲ : Helicobacter pylori에 의해 유발된 마우스 위암에서 염증매개인자의 역할 The role of inducible nitric oxide synthase and cyclooxygenase-2 in H. Pylori-associated gastric carcinogenesis

남기택,오상연,조현무,이국경,강진석,제정환,최미나,한상욱,김대용,장동덕,양기화,안병우 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

feficotorfer fyf☞ri(Hp)가 위암파 관련이 있다는 역학적인 증거는 많이 있지만 이에 대한 정확한 기전에 대해선 밝혀져 있지 않고 있으며 실험동물 모델도 적절하지 못한 것으로 알려져있다. 본 실험에서는 위암의 원인으로 알려져 있는 f, fyforf'(Hp)를 이용하여 마우스에서 위암 모델을 확립하고 만성염증과정 중에 생성되는 리0와 COX-2 등의 발현이 위암발생에 미치는 명향을 통하여 예방과 치료를 위한 점근을 시도하고자 하였다. 마우스를 7군으로 나누어서 1, 2, 3, 4군의 등물은 MNU를 증류수에 200ppm 농도로 음수병득 이용하띤 10주간 격주로 투여하였으며 MHU 음술 투여 1주 휴씩 후 배양한 f. fyrofi 를 약 109cru/rfll 로 맞춰 한 마리당 0.1ml 씩 이틀 간격으로 세 번에 걸쳐 하룻방 금식시킨 1, 2, 3, 5, 6, 7군기 마우스의 위장에 투입하떴다. 균 투입을 마친 후 다응 날부터 2군쏙 6군은 iNOS 억제제인 aminoguanidine(AG)을 음수병으로 툰여하였으며 3군과 7군은 COX-2 척제제인 nimesulide(NSD)를 투여하였다. 위의 종양발생양상을 샅최보면 bfNU와 Hp만을 투여한 1 관 ; (hfNU +Hp), 2군 : iNO을 inhibitor 투여군(MNU+HP+AG'1. 3군 ;CO딘-2 Inilibitor 투여군(MNU누Hp누 NSD), 4군 ,MNlf 단독투여군, 5군 ;Hp 단독투여춘, 6군 ; 러p 단독에 AG투여군, 7군 , Hp 단독에 NSD투여군의 종양발샐을은 각각 쁜.Bff(l1/16), 70.6%f12/ti), 했.9ff(7/18), 10%(1/10), Off(O/IS)0%(O/S), 0%(O/5)의 발쟁율을 보여 iNOS 억제제인 AC은 좁양발생을 억계하지 못하였으며, COX-2억제제인 NSD 는 종양발생을 유의적으로 감소시켰다. 콩양발생개수에서는 2.62±0.36, 1.41츠0.14, 0.44 르0.12, 0.10±0.10을 보여 AC와 NSD에서 유의성 있게 발생개수를 줄였다. Hp 단독투여에 의해즌는 종양발생이 나타나지 않았으며 HP+AG, Hp+ IfSD 추여군에콕 시험증료 시점에 약물에 의해 Hp의 제균효과가 있는지의 여부를 확인끓기 위하여 PCR을 이용하여 확인한 결과 모두 양성인 것으로 나타나 Hp의 제균효과에 의한 촐양발생 억제가 일어나지는 않았다. 위의 결과로 볼 때 Hp는 위암발생을 촉진하는 것으로 나타났고 딘p 감염시 매개되는 염증인자를 억제하였을 때 종양발생을 억제하는 것으로 위암 발생에서 염증매개인자는 종양을 촉진하는 것으로 나타났으며 it,705 억제제쓱 COX-』 억제제의 위알 예밭효과fl는 효과적일 것으로 사료된다 In spite of a large volume of epidemiological evidence indicating significant relationship between H. pylori infection and gastric adenocarcinoma, a doubt still exists on an elevated risk of stomach cancer by H. pylori infection due to lack of direct evidence of their exact mechanistic link. It is, therefore, essential to have an appropriate animal model for detailed analysis of the role of H. pylori played in gastric carcinogenesis. There is a wealth of evidence to support that over production of inducible nitric oxide synthase(iNOS) and cyclooxygenase-2(COX-2) is involved in the pathogensis of various cancer in both rodents and humans. The aim of this study was to establish a mouse model for H. pylori-associated gastric carcinogenesis and to identify the role of inducible nitric oxide synthase(iNOS) and cyclooxygenase-2(COX-2) played during the gastric carcinogenesis in mice. Eighty-three specific pathogen free, six-week-old male C57BL/6 mice were randomly divided into seven groups. Animals of the group 1, 2, 3, 4 were given MNU in their drinking water at the concentration of 200 p.p.m. for total five cycles of one-week regimen with one-week pause. After completion of MNU administration, they were given autoclaved distilled water for one weeks, and groups 1, 2, 3, 5, 6, 7 were inoculated with H. pylori. After completion of H. pylori. inoculation, groups 2 and 6 were given aminoguanidine in their drinking water at concentration of 1000p.p.m. and animals of group 3 and 7 were given the diet containing 200 ppm nimesulide at 12 weeks of age. All animals were killed at 50 weeks of age. The incidences of the glandular stomach tumors in the group 1, 2, 3 and 4 were 87.5%(14/16), 76.4%(13/17), 44.4(8/18), 10.0%(1/10), respectively and the tumor incidence of group 3(MNU→Hp+nimesulide) was significantly lower than those of group 1(MNU→Hp) at the value of P<0.01. The average numbers of tumors of group 2(MNU→Hp+AG : 1.41±0.24) and group 3(MNU→Hp+nimesulide : 0.44±0.12) were significantly lower than those of group 1(MNU→Hp : 2.62±0.36) at the value of P<0.05. Therefore, overproduced iNOS and COX-2 plays an important role in mice gastric carcinogenesis. We concluded iNOS and COX-2 inhibitor have good effects on gastric carcinogenesis.

수지말단부 손상의 분류와 재건

박대환,한동길,안기영 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

Finger tip injuries are in increasing tendency and the treatment must be focused toward preserving length and providing normal sensitivity. The 61 injured digits distal to DIT joint in 49 patients were managed in various procedures from May, 1990 to June, 1991. The authors classified the injured digits into 6 groups and selected the best surgical procedures according to the extent of the injuries. The 6 groups were : A. Volar skin and pulp loss without exposed bone B. Large volar skin and pulp loss with exposed distal phalanx C. Straight-transecton involving nail bed injury. D. Dorsally directed injury with little remaining nail bed E. Germinal matrix injury F. Injury at DIT joint level Tentatively recomonended surgical procedures by the extent of injury were : 1. Secondary intention or skin graft for level A 2. Local flap coverage for level B 3. Composite graft or Local advancement flap for level C 4. Local flap coverage or primary closure after bone shortening and residual nail ablation for group D 5. Micro-replantation or distant flap or local flap according to the state of the injury for group E and F