• Pediatric Infection and Vaccine
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• 제23권3호
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• pp.188-193
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• 2016

목적: 경부 림프절 종대를 먼저 보인 가와사키병(node-first presented Kawasaki disease [NFKD])에 대한 임상 연구를 통해 세균 경부 림프절염(bacterial cervical lymphadenitis [BCL]), 전형적인 가와사키병(Kawasaki disease [KD])과 구별되는 특징을 찾고자 하였다. 방법: 2007년부터 2015년까지 BCL, NFKD, 전형적인 KD로 입원한 환자들의 의무기록을 검토하여 인구학적 특성, 임상 양상, 혈액검사 및 영상의학적 검사 결과를 후향적으로 비교 분석하였다. 결과: 22명의 BCL, 37명의 NFKD, 132명의 전형적인 KD 환자가 연구에 포함되었다. BCL과 NFKD의 비교에서 BCL군의 입원 기간이 더 길었고 NFKD군은 양측, 다발형 림프절 비대를 보이면서 혈소판 수가 적고 호중구 백분율과 CRP 수치가 높았다. NFKD와 전형적인 KD의 비교에서 NFKD군의 나이가 더 많았고 백혈구 수, 호중구 백분율, 호중구 수, CRP 수치가 높고 혈소판 수와 ALT 수치가 낮았다. 결론: 발열과 경부 림프절 종대가 있는 환자에서 호중구 백분율과 CRP 수치가 높고 혈소판 수치가 높지 않으면서 양측, 다발형 경부 림프절 비대를 보인다면, KD의 진단 및 치료가 지연되지 않도록 NFKD 진단을 신속하게 고려하여야 한다.

• Journal of Chest Surgery
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• 제43권5호
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• pp.506-512
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• 2010

배경: 이 연구는 비소세포암 환자에서 종격동 임파선 전이 여부를 정확히 예측하기 위해서 PET/CT에서 종격동 임파선과 폐종괴의 FDG 섭취비와 폐종괴의 Glut-1 발현 정도를 이용하여 분석 하고자 하였다. 대상 및 방법: PET/CT에서 폐종괴와 종격동 임파선에서 측정할 수 있는 정도의 FDG섭취가 있는 환자를 대상으로 하였다. FDG 섭취비는 종격동 임파선의 섭취를 폐종괴의 섭취로 나누어 구하였다. 폐종괴의 Glut-1 발현은 발현 면적으로 나타내었다. 결과: 폐종괴와 종격동 임파선의 mSUV값은 악성군에서 각각 $7.4{\pm}2.2$와 $4.2{\pm}2.2$, 양성군에서 각각 $7.6{\pm}3.7$와 $2.8{\pm}6.9$였다. FDG의 섭취비는 악성군과 양성군에서 각각 $0.58{\pm}0.23$과 $0.45{\pm}0.20$ (p<0.05)였다. FDG 섭취비와 Glut-1 발현 정도를 결합한 모델 중에서 {p/(1-p)}=ratio+glut+ratio${\times}$glut의 식으로 표시된 모델이 FDG 섭취비만을 이용한 모델 보다 정확히 종격동 임파선의 악성 정도를 예측할 수 있었다. 결론: 염증성 폐질환의 병력이 있는 일부 폐암 환자에서 Glut-1 발현 정도를 고려한 FDG 섭취비를 분석한 모델은 종격동 임파선의 악성 정도를 정확히 진단할 수 있다.

• 한국방사선학회논문지
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• 제3권1호
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• pp.11-15
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• 2009

본 연구에서는 헤테로 접합을 이용하여 누설전류를 저감 시키는 기술을 적용하여 Particle-In -Binder을 이용한 방사선 영상 센서의 변환 물질을 개발하였다. 이는 디지털 방사선 영상 검출기의 두 가지 방식 중 하나인 직접방식에 사용되는 핵심 소자로 기존의 비정질 셀레늄(Amorphous Selenium)을 대체하여 더욱 효율이 높은 후보 물질들이 연구되어지는 가운데 태양전지와 반도체 분야에서 이미 많이 사용되어온 이종접합(Hetero junction)을 이용해 누설 전류를 저감 시키는데 그 목적이 있다. 본 연구에서 사용되는 Particle-In -Binder 제작 방법은 검출 물질 제작이 용이하고 높은 수율과 대면적의 검출기 제작에 적합하나 높은 누설 전류가 의료 영상 시스템에 있어서 문제가 되어 오고 있다. 이러한 단점을 보완하기 위해 다층 구조를 이용하여 누설 전류를 저감시킨다면 Particle-In -Binder을 이용하여 간편하게 향상된 효율의 디지털 방사선 검출기를 제작 할 수 있다고 사료 되어 진다. 본 연구에서는 누설전류 및 민감도, 그리고 선형성에 대한 전기적 신호를 측정하여 제작된 다층 구조의 방사선 검출 물질의 특성 평가가 이루어 졌다.

• 핵의학기술
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• 제12권1호
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• pp.33-38
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• 2008

Purpose: The Gated cardiac blood pool scan is non-invasive method that a quantitative evaluation of left ventricular function. Also this scan have shown the value of radionuclide ejection fraction measurements during the course of chemotherapy as a predictor of cardiac toxicity. Therefore a reliable method of monitoring its cardiotoxic effects is necessary. the purpose of this study is to minimize the overestimate of left ventricular ejection fraction (LVEF) by modified body position to reduce the influence of scattered rays from surrounding organs of the heart in the background region of interest. Materials and Methods: Gated cardiac blood pool scan using in vivo $^{99m}Tc$-red blood cell (RBC) was carried out in 20 patients (mean $44.8{\pm}8.6$ yr) with chemotherapy for a breast carcinoma. Data acquisition requires about 600 seconds and 24 frames of one heart cycle by the multigated acquisition mode, Synchronization deteriorates toward the end of the cycle and with the distance from the trigger signal (R-wave) by ECG gating. Gated cardiac blood pool scan was studied with conventional method (supine position and the detector head in $30-45^{\circ}$ left anterior oblique position and caudal $10-20^{\circ}$ tilt) and compared with modified method (left lateral flexion position with 360 mL of drinking water). LVEF analysis was performed by using the automatically computer mode. Results: The ROI counts of modified scan method were lower than LV conventional method ($1429{\pm}251$ versus $1853{\pm}243$, <0.01). And LVEF of modified method was also decrease compared with conventional method ($58.3{\pm}5.6%$ versus $65.3{\pm}6.1%$, <0.01). Imaging analysis indicated that stomach was expanded because of water and spleen position was changed to lateral inferior compared with conventional method. Conclusion: This study shows that the modified method in MUGA reduce the influence of scattered rays from surrounding organs. Because after change the body position to left lateral flexion and drinking water, the location of spleen, left lobe of liver and stomach had changed and they could escaped from background ROI. Therefore, modified method could help to minimize the overestimate LVEF (%).

• 폴리머
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• 제36권5호
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• pp.586-592
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• 2012

산화철($Fe_3O_4$은 세포에 의해 섭취된 후 대사반응에 의해 분비되므로 세포독성을 나타내지 않는다. 따라서 산화철 나노입자는 MRI 촬영을 하기에 앞서 조영제로서 널리 사용되고 있다. 본 연구에서는 통상의 공침법으로 산화철 나노입자를 합성하고 폴리에틸렌글리콜을 스페이서로 하여 혈관내피세포 및 방광암 세포막의 IL-4 리셉터에 특이적으로 반응하는 homing 펩타이드(AP)를 고정화하였다. AP를 고정화한 산화철 나노입자의 크기는 수용액 상에서 약 39 nm이었다. 섬유아세포 및 방광암세포를 이용하여 AP고정화 산화철 나노입자의 uptake를 조사한 결과 섬유아세포에는 선택적 uptake를 발견할 수 없었으나 방광암세포에는 선택적으로 uptake됨을 알 수 있었다. 따라서 AP 고정화 산화철 나노입자는 조기 암진단용 조영제로서 가능성을 지니고 있다고 할 수 있다.

• The Korean Journal of Pain
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• 제25권1호
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• pp.22-27
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• 2012

Background: The common causes of lower back pain with or without leg pain includes disk disease and spinal stenosis. A definitive diagnosis is usually made by means of magnetic resonance imaging (MRI), but treatment is often difficult because the MRI findings are not consistent with the symptoms of the patient in many cases. The objective of this study was to observe the correlation between the patterns of epidurography performed in patients having lower back pain with or without leg pain and the position or severity of the pain as subjectively described by the patients. Methods: The subjects of this study were 69 outpatients with lower back pain with or without leg pain who visited our clinic and complained of predominant pain on one side. We performed caudal epidural block using an image intensifier. A mixture of the therapeutic drug and the contrast agent (10 ml) was injected to observe the contrast flow pattern. The patients who complained of predominant pain on one side were divided into the left side group and the right side group. A judgment of inconsistency was made if the contrast agent flowed to the side of the pain, while a judgment of consistency was made if the contrast agent flowed to the opposite side of the pain. The degree of the drug distribution was evaluated by counting the number of cells to which the contrast agent's flowed for evaluating the correlation between the contrasted cell and the severity of pain (one group ${\leq}$ VAS 7, the other group ${\geq}$ VAS 8) the degree of the contrast agent's contrast was evaluated by dividing and counting an image into 15 cells (the left, right, and middle sections at each level of L4, L5, S1, S2, and S3). Results: Thirty out of the 69 patients who had laterality in pain, that is, those who complained of predominant pain on one side, showed that the laterality of the pain and the contrast agent flow was consistent, while 39 patients showed that the laterality was inconsistent (P: 0.137). The evaluation of the correlation between the pain and the contrast agent flow showed that the mean number of contrasted cells was $9.0{\pm}2.2$ for the 46 patients in the group with a VAS of 7 or lower and $6.5{\pm}2.0$ for the 23 patients in the group with a VAS of 8 or higher, indicating that the former group showed a significantly greater number of contrasted cells (P < 0.001). Conclusions: This study, conducted with patients having lower back pain with or without leg pain, showed that the contrast flow pattern of caudal epidurography had a significant correlation with the severity of the pain but not with the laterality of the pain.

• International Journal of Oral Biology
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• 제31권4호
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• pp.141-148
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• 2006

The effects of adenosine triphosphate(ATP) on salivary glands have been recognized since 1982. The presence of purinergic recepetors(P2Rs) that mediate the effects of ATP in various tissues, including parotid and submandibular salivary gland, has been supported by the cloning of receptor cDNAs and the expression of the receptor proteins. P2Rs have many subtypes, and the activation of these receptor subtypes increase intracellular $Ca^{2+}$, a key ion in the regulation of the secretion in the salivary gland. The apical pores of taste buds in circumvallate and foliate papillae are surrounded by the saliva from von Ebner salivary gland(vEG). Thus, it is important how the secretion of vEG is controlled. This study was designed to elucidate the roles of P2Rs on salivary secretion of vEG. Male Sprague-Dawley rats (about 200 g) were used for this experiment. vEG-rich tissues were obtained from dissecting $500-1,000\;{\mu}m$ thick posterior tongue slices under stereomicroscope view. P2Rs mRNA in vEG acinar cells were identified with RT-PCR. To observe the change in intracellular $Ca^{2+}$ activity, we employed $Ca^{2+}-ion$ specific fluorescence analysis with fura-2. Single acinar cells and cell clusters were isolated by a sequential trypsin/collagenase treatment and were loaded with $10\;{\mu}M$ fura -2 AM for 60 minutes at room temperature. Several agonists and antagonists were used to test a receptor specificity. RT-PCR revealed that the mRNAs of $P2X_4$, $P2Y_1$, $P2Y_2$ and $P2Y_3$ are expressed in vEG acinar cells. The intracellular calcium activity was increased in response to $10\;{\mu}M$ ATP, a P2Rs agonist, and 2-MeSATP, a $P2Y_1$ and $P2Y_2R$ agonist. However, $300\;{\mu}M\;{\alpha}{\beta}-MeATP$, a $P2X_1$ and $P2X_3R$ agonist, did not elicit the response. The responses elicited by $10\;{\mu}M$ ATP and UTP, a $P2Y_2R$ agonists, were maintained when extracellular calcium was removed. $10\;{\mu}M$ suramin, a P2XR antagonist, and reactive blue 2, a P2YR antagonist, partially blocked ATP-induced response. However, when extracellular calciums were removed, suramin did not abolish the responses elicited by ATP. These results suggest that P2Rs play an important role in salivary secretion of vEG acinar cells and the effects of ATP on vEG salivary secretion may be mediated by $P2X_4$, $P2Y_1$, $P2Y_2$, and/or $P2Y_3$.

• Imaging Science in Dentistry
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• 제39권3호
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• pp.121-132
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• 2009

Purpose : To investigate the effects of 2-deoxy-D-glucose (2-DG) and quercetin (QCT) on gene expression of bone sialoprotein (BSP) and osteocalcin (OC) during the differentiation in irradiated MC3T3-E1 osteoblastic cells. Materials and Methods : When MC3T3-E1 osteoblastic cells had reached 70-80% confluence, cultures were transferred to a differentiating medium supplemented with 5 mM 2-DG or $10{\mu}M$ QCT, and then irradiated with 2, 4, 6, and 8 Gy. At various times after irradiation, the cells were analyzed for the synthesis of type I collagen, and expression of BSP and OC. Results : The synthesis of type I collagen in cells exposed to 2 Gy of radiation in the presence of 2-DG or QCT showed no significant difference compared with the control group within 15 days post-irradiation. When the cells were irradiated with 8 Gy, 2-DG facilitated the irradiation mediated decrease of type I collagen synthesis, whereas such decrease was inhibited by treating with QCT. During MC3T3-E1 osteoblastic cell differentiation, the mRNA expression of BSP and OC showed the peak value at 14 days and 21 days, respectively. 2-DG or QCT treatment alone decreased the level of BSP mRNA, but increased the OC mRNA level only at early time of differentiation (day 7). In the cells irradiated with 2, 4, 8 Gy, the mRNA expression of BSP and OC decreased at 7 days after the irradiation. The cells were treated with various dose of radiation in the presence of 2-DG or QCT, the mRNA level of both BSP and OC increased although this increase was observed at low dose of radiation (2 Gy) and at the early stage of differentiation. However, when the cells were exposed to 4, 6, or 8 Gy, the increase of BSP and OC mRNAs was detected only in cells co-incubated with QCT. Conclusion : This study demonstrates that 2-DG and QCT affect differently the expression of bone formation related factors, type I collagen, BSP, and OC in the irradiated MC3T3-E1 osteoblasic cells, according to the dose of radiation and the times of differentiation. Overall, the present findings suggest that 2-DG and QCT could have the regulatory roles as radiation-sensitizer and -protector, respectively.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.85-90
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• 2001

Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

• 대한안과학회지
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• 제59권11호
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• pp.1097-1102
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• 2018

목적: 클로르페나피르 음독 후 중추신경계 손상을 동반한 독성 시신경병증 1예를 보고하고자 한다. 증례요약: 44세 여자가 7일 전부터의 양안 시력저하를 주소로 내원하였다. 환자는 내원 2주 전 자살 목적으로 클로르페나피르 한 모금을 음독했고, 직후 근처 병원에서 위세척을 시행하였다. 초기 최대교정시력은 우안 안전수지 30 cm, 좌안 안전수동이었다. 양안 동공은 5.0 mm로 커져 있었고, 빛에 대한 반응은 느렸으며 좌안에는 상대구심동공운동장애가 관찰되었다. 안저검사에서 양안 시신경유두부종이 관찰되었고, 뇌자기공명영상에서 양안 시신경과 속섬유막, 뇌량, 중소뇌각, 뇌간 등 백질 신경로를 따라 양쪽에 대칭적인 고강도신호가 관찰되었다. 클로르페나피르 중독으로 인한 독성 시신경병증으로 진단 후, 고용량 스테로이드치료를 3일간 시행하였으나 양안 최대교정시력은 광각무로 악화되었다. 3개월 후, 안저검사에서 양안 시신경위축이 관찰되었고, 빛간섭단층촬영에서 망막신경섬유층 및 신경절세포-내망상세포층 두께가 감소하였다. 결론: 매우 적은 양이라도 클로르페나피르에 노출되면 적절한 치료에도 불구하고 잠복기를 거쳐 심각한 시신경손상이 발생할 수 있으므로 주의해야 하겠다.