• Journal of Digestive Cancer Research
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• 제1권1호
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• pp.6-16
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• 2013

식생활의 서구화와 대장암 검진의 증가로 인하여 국내의 대장암 유병률은 지속적으로 증가하고 있으며, 최근 보고에 의하면 남자에서는 종양 발생률 2위, 여자에서는 종양 발생률의 3위를 차지하고 있다. 비록 대장내시경이 대장암의 진단과 선별검사에 아주 효과적인 방법이지만, 여전히 대장암의 20-25%는 이미 진단 당시에 전이를 동반하고 있는 것으로 되어 있다. 최근 10년 동안 이러한 전이성대장암의 고식적인 치료로 irinotecan과 oxaliplatin 등의 약제들의 개발과 이들의 다양한 조합에 관련된 연구들이 보고되어 왔으며, 분자생물학적인 발전에 힘입은 표적 치료제의 개발과 이에 대한 다양한 연구들은 향후에도 진행성대장암 환자들의 종양 반응률과 생존기간을 증가시킬 것으로 기대된다.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.435-440
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• 2023

Mesenteric injury occurs rarely in cases associated with blunt abdominal trauma. Despite its low incidence, mesenteric injury can lead to fatal outcomes such as hypovolemic shock due to hemoperitoneum or sepsis due to intestinal ischemia, or perforation-related peritonitis. For mesenteric injuries, especially those involving massive bleeding, intestinal ischemia, and perforation, the standard treatment is surgery. However, in the case of operative management, it should be borne in mind that there is a possibility of complications and mortality during and after surgery. The usefulness of transcatheter arterial embolization (TAE) is well known in solid organs but is controversial for mesenteric injury. We present a 75-year-old man with mesenteric injury due to blunt abdominal trauma. Initial abdominal computed tomography showed no hemoperitoneum, but a mesenteric contusion and pseudoaneurysm with a diameter of 17 mm were observed near the origin of the superior mesenteric artery. Since there were no findings requiring emergency surgery such as free air or intestinal ischemia, it was decided to perform nonoperative management with TAE using microcoils in hybrid emergency room system. TAE was performed successfully, and there were no complications such as bleeding, bowel ischemia, or delayed bowel perforation. He was discharged on the 23rd day after admission with percutaneous catheter drainage for drainage of mesenteric hematoma. The authors believe that treatment with TAE for highly selected elderly patients with mesenteric injuries has the positive aspect of minimally invasive management, considering the burden of general anesthesia and the various avoidable intraoperative and postoperative complications.

• Genomics & Informatics
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• 제21권3호
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• pp.29.1-29.9
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• 2023

Preterm birth (PTB), a pregnancy-related disease, is defined as a birth before 37 weeks of gestation. It is a major cause of maternal mortality and morbidity worldwide, and its incidence rate is steadily increasing. Various genetic factors can contribute to the etiology of PTB. Vascular endothelial growth factor A (VEGFA) gene is an important angiogenic gene and its polymorphisms have been reported to be associated with PTB development. Therefore, we conducted a case-control study to evaluate the association between VEGFA rs699947, rs2010963, and rs3025039 polymorphisms and PTB in Korean women. A total of 271 subjects (116 patients with PTB and 155 women at ≥38 weeks of gestation) were analyzed in this study. The genotyping of VEGFA gene polymorphisms was performed using polymerase chain reaction- restriction fragment length polymorphism. No significant association between the patients with PTB and the control groups was confirmed. In the combination analysis, we found a significant association between PTB and VEGFA rs699947 CC-rs2010963 GG-rs3025039 CC combination (odds ratio, 3.77; 95% confidence interval, 1.091 to 13.032; p = 0.031). The VEGFA rs699947, rs2010963, and rs3025039 polymorphisms might have no genetic association with the pathogenesis of PTB in Korean women. However, the combination analysis indicates the possibility that VEGFA acts in PTB pathophysiology. Therefore, larger sample sets and replication studies are required to further elucidate our findings.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.458-466
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• 2024

Objective : Several clinical studies have explored the feasibility and efficacy of radiosurgical treatment for mesial temporal lobe epilepsy, but the long-term safety of this treatment has not been fully characterized. This study aims to report and describe radiation-induced cavernous malformation as a delayed complication of radiosurgery in epilepsy patients. Methods : The series includes 20 patients with mesial temporal lobe epilepsy who underwent Gamma Knife radiosurgery (GKRS). The majority received a prescribed isodose of 24 Gy as an adjuvant treatment after anterior temporal lobectomy. Results : In this series, we identified radiation-induced cavernous malformation in three patients, resulting in a cumulative incidence of 18.4% (95% confidence interval, 6.3% to 47.0%) at an 8-year follow-up. These late sequelae of vascular malformation occurred between 6.9 and 7.6 years after GKRS, manifesting later than other delayed radiation-induced changes, such as radiation necrosis. Neurological symptoms attributed to intracranial hypertension were present in those three cases involving cavernous malformation. Of these, two cases, which initially exhibited an insufficient response to radiosurgery, ultimately demonstrated seizure remission following the successful microsurgical resection of the cavernous malformation. Conclusion : All things considered, the development of radiation-induced cavernous malformation is not uncommon in this population and should be acknowledged as a potential long-term complication. Microsurgical resection of cavernous malformation can be preferentially considered in cases where the initial seizure outcome after GKRS is unsatisfactory.

• Clinics in Shoulder and Elbow
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• 제27권2호
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• pp.169-175
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• 2024

Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients. Methods: A retrospective review was performed to identify patients with available preoperative shoulder CT who subsequently underwent shoulder arthroplasty procedures at a single institution between 2015 and 2021. Data including age, sex, and smoking status were obtained. Radiology reports for CTs were reviewed for incidental findings and categorized based on location, tissue type, and/or body system. The rate of incidental findings and the rate at which further follow-up was recommended by the radiologist were determined. Results: A total of 617 patients was identified. There were 173 incidental findings noted in 146 of these patients (23.7%). Findings ranged from pulmonary (59%), skin/soft tissue (16%), thyroid (13%), vascular (9%), spinal (2%), and abdominal (1%) areas. Of the pulmonary findings, 50% were pulmonary nodules and 47% were granulomatous disease. Overall, the final radiology report recommended further follow-up for 50% of the patients with incidental findings. Conclusions: Incidental findings are relatively common in preoperative CTs obtained for shoulder arthroplasty, occurring in nearly one-quarter of patients. Most of these findings are pulmonary in nature. Overall, half of the patients with incidental findings were recommended for further follow-up. These results establish population data to guide orthopedic surgeons in patient counseling. Level of evidence: III.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.10.3-11
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• 1982

근래에 기도 협착의 발생빈도는 수술요법의 괄목할만한 진전과 Low pressure cuff가 개발된 후 현저히 감소하고 있으나 호흡부전으로 Ventilator를 사용하는 경우와 심한 상기도 감염이나 손상이 있을 때 또는 장기간 삽관을 함으로서 발생하는 기관 협착증은 아직도 이비인후과 영역에 있어서 난제라고 하겠다. 이러한 기도 협착증의 치료로는 기계적으로 확장을 하거나 협착 부위를 수술적으로 제거하고 조직을 이식하는 여러 방법들이 있어서 그적응증에 따라 각각 사용되어 오고 있으나 아직까지도 만족할만한 결과를 얻지 못하는 때가 많은 실정이다. 1959년 Lester가 우연히 늑골의 잔존 연골피막으로부터 신생 연골이 재생된 것을 발견한 이후 Skoog(1972), Sohn(1974), Ohlsen(1975)등은 동물 실험을 통하여 연골 피막으로 부터의 연골 재생에 관하여 다각적인 보고를 하였다. 임상적으로 이개, 비중격, 늑골 및 피부편등 여러 가지 다양한 조직들이 기관의 결손 또는 협착 부위의 재생에 사용되어 왔으나 기관의 정상적인 지지 조직의 연골이며 또한 연골피막이 연골의 재생을 가능케 한다는 점에 입각하여 기관의 재건에 연골피막의 사용가능성을 알아 보고저 다음의 실험을 하였다, 가토의 이개연골에서 연골피막을 취한후 인위적으로 만든 가토의 기관 결손부위에 이식한 다음 2주부터 8주경과 할때 까지의 재생 변화를 관찰하여 다음과 같은 결론을 얻었다. (결론) 1) 기관결손 부위의 재생은 대조군에서는 결손부위에 섬유질 및 혈관으로 구성되었으나 이식군에서는 비후된 연골피막과 섬유질로 구성되었다. 2) 점막의 재생은 대조군과 이식한군 모두에서 2주경과 표본부터 정상점막으로 완전히 재생 되었다. 3) 이식 부위의 변화를 보면 2주-모세혈관의 확장과 염증반응을 동반하며 섬유조직의 증식시작이 관찰되었다. 4주-점차 모세혈관의 확장이 감소하며 염증반응의 감소가 있으며 점막하층의 섬유조직의 증식이 있고 1개의 표본에서 연골피막내에 미숙연골 세포군이 존재. 6주-경도의 모세혈관의 확장과 만성염증반응이 존재하며 점막하층의 섬유조직화가 존재하였으며 2개의 표본에서 연골피막내에 연골 세포군 및 골화현상이 존재하였다. 8주-경미한 모세혈관의 확장이 존재하였으나 염증반응은 소실되었고 점막하층에 심한 섬유화를 동반하였다. 표본 2개에서 연골 피막내에 연골 세포군의 존재가 관찰되었다. 4 ) 이식방법을 달리한 경우에도 연골 및 점막의 재생에는 유의한 차이를 발견할 수 없었다. 5) 연골피막 이식부위에서 미숙연골 세포군과 endo-chondrial ossification을 관찰할 수 있었으나 대조군에서는 결손부위의 섬유화만이 관찰되었다. 이상의 결과로 볼때 연골피막은 기관결손부위의 재진에 적합한 조직이라할 수 있었다. 그러나 40 례의 표본중 5례의 표본에서만 연골의 세포군을 관찰할 수 있어 이로 미루어 볼때 연골피막으로 부터 신생 연골이 재생된다 확인하기는 불충분하다고 생각되며 앞으로의 추시가 요망된다 하겠다.

• 식물병연구
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• 제9권2호
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• pp.79-84
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• 2003

2001년 8월에서 2002년 7월까지 경기도내 주요 시설하우스 재배지에서 시클라멘 시들음병 발생을 조사한 결과 전지역에서 발생이 확인되었으며, 김포에서는 발병주율이 42.7%까지 되었다. 시들음병 발생은 관행적인 지상관수방법보다 저면관수에서 발생이 더 심하였다. 발병된 시클라멘 잎은 황화되고 병이 진전되면 고사하였으며 구근에서는 갈변 증상이 관찰되었다. 갈변된 구근 조직에서 병원균을 분리하여 fusarium oxysporum f. sp. cyclaminis로 동정하였다. 발병지 상토를 수거하여 시클라멘을 이식했을 때 100% 발병하였다. 저항성 품종 선발에서는 'Matis red', 'Schubert', 'Victoria', 'Chopin'의 4품종만이 저항성 품종으로 검정 되었을 뿐 대부분의 품종이 감수성이었다. 시들음병 방제약제 선발 결과 방제 효과는 비교적 낮았으나 병원균 접종 전 약제처리시 베노밀 수화제와 후루 디옥소닐 액상수화제의예방 효과가 인정되었다. 그리고 병을 Fusarium oxysporum f. sp. cyclaminis에 의한 시클라멘 시들음병으로 명명할 것을 제안한다.

• 한국환경보건학회:학술대회논문집
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• 한국환경보건학회 2005년도 Proceedings of KSEH.Minamata Forum
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• pp.87-94
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• 2005

Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.

• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.51-59
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• 2018

Objective : The feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA). Methods : Patients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed. Results : A total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p<0.001) and hypertension (p<0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68). Conclusion : DUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.456-461
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• 2018

목동맥 스텐트 삽입술은 목동맥 내막절제술에 적합하지 않은 환자에게 시행할 수 있는 목동맥 협착증의 대체 치료법으로 알려져 있다. 목동맥 내막절제술, 혈관성형술 또는 스텐트 삽입술 후에 드문 부작용으로 뇌내출혈이 발생할 수 있고, 이러한 출혈이 발생하는 원인은 대부분의 경우 재관류 손상과 관련이 있는 것으로 추정하고 있다. 이전의 연구에서는 내막절제술과 비교하여 목동맥 스텐트 삽입술 후 뇌내출혈의 빈도가 더 높다고 보고한 바 있다. 본 연구에서는 뇌경색으로 내원한 80세 남자환자를 대상으로 증례보고를 통해 동일 분야 연구에 활용하고자 자료 분석을 하였다. 80세 남자가 갑자기 발생한 오른 팔의 근력저하를 주소로 방문하였다. 왼쪽 속목동맥의 90% 협착이 발견되어 목동맥 스텐트 삽입술을 시행하였고, 시술 후 실시한 뇌 CT에서 시상을 포함하는 후대뇌동맥 영역의 뇌출혈이 뇌실내출혈까지 진행되어 있음을 관찰하였다. 이러한 출혈은 스텐트 삽입술이 시행된 동맥에서 공급될 가능성이 낮은 혈관 영역에서 발생했기 때문에, 이 경우에 내막절제술 시행 후 과다혈류에 의한 출혈과 다른 양상을 확인하였다.