천식에서 관련 유전자들 사이의 상호작용과 천식에대한 영향

이준혁,박성우,장안수,박춘식 순천향대학교 의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

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커뮤니티 槪念을 導入한 都市整備事業 推進方案에 관한 硏究 : 도시 및 마을만들기 手法을 中心으로

장준호,이인혁 안양대학교 산업기술연구소 2000 自然科學硏究 Vol.7 No.-

시민의식의 성숙과 행정 측의 새로운 패러다임의 변화 요청으로 1990년대 들어서 도시 및 마을만들기의 사고방식이 급속히 보급되고 있는 실정이다. 이러한 상황에서 현재 도시만들기의 사례가 급격히 늘어나고 있으며 지방자치의 본격화와 시민들의 적극적인 활동으로 도시만들기의 증가 추세는 앞으로도 더욱 지속되고 강화될 전망이다. 그러나 일부 주민의 이해부족과 동참 거부, 행정과 주민의 이해 상충, 주민 참여의 적극성 결여, 홍보 및 지원 부족, 정보 부족 등의 문제들이 속출되고 있다. 이것은 도시만들기의 주체인 행정, 기업, 주민, 전문가 사이의 계획적인 연계체계가 부족해서 발생되었다고 본다. 이러한 문제들을 극복하기 위해 도시만들기는 인간 정주공간을 보다 윤택하고 살기 좋은 공간으로 변화시키는데 주력해야 한다. 인간이 살기 좋은 공간의 구성을 위해서는 지구 기반시설 정비, 건축물 정비, 거리미 보전, 상점가 활성화, 기존 구 시가지 개선, 지역 종합개발 등의 활동이 이루어져야 할 것이다. The purpose of this study is to make a new community planning paradigm by means of citizen participation. As a result of this study the following conclusions have been drawn. In order to make a successful redevelopment and district environment revitalization projects we must induce citizen participation, informing of district situation, supporting of monetary fund, enhancing of public & private partnership, revising of urban planning law and so on.

젊은 남자에게 발생한 통상성 간질성 폐렴과 동반된 폐암 1예

박종숙,이준혁,박성우,장안수,박춘식,박재성,백상현,고은석,신화균 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Usual interstitial pneumonia(UIP) is relatively rare disease of lung parenchyme under the age of 50. Lung cancer is reported to occur as a complication of UIP, but has not been reported in young age patient with UIP in Korea. A 35-year-old man was admitted to the hospital because of dyspnea, cough and mild fever. He had been suffered from dyspnea during 3 years. The dyspnea worsened recent 1 month ago. He had been treated with pneumonia at another hospital during 4 months before this admission. Chest radiographs and High resolution CT showed subpleural and basal dominant reticular opacities in both lung with no change until now. He was smoker and his occupation was car engine-man dealing with benzene. UIP is suspected by history and radiologic findings. Operation for open lung biopsy was performed to obtain lung specimen via video-assisted thoracoscopic surgery. Patient's pathologic examination showed UIP combined with adenocarcinoma in RLL superior segment and posterobasal segment and RLL lobectomy was done. After operation, the patient has been in cancer free condition so far. We report a case of UIP combined with lung cancer in young man with brief review of the literature.

추적관찰 중 종괴의 크기가 커진 경화성 혈관종 1례

안형수,장안수,이준혁,박성우,고은석,백상현,박재성,허균,신화균,박춘식 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

We report a case of a sclerosing hemangioma of the lung with increased size during follow up, a rare benign neoplasm of the lung. A 32-year-old woman had round increased opacity in right upper lobe on posteroanterior chest radiograph. That lesion has grown slowly over four years. Computed tomographic scan showed a well circumscribed lung mass in medial aspect of right upper lobe. Radiological differential diagnosis for the lesion included inflammatory pseudotumor, atypical carcinoid, lung cancer and localized fibrous tumor of pleura. Nonspecific findings were shown by the bronchoscopy and percutaneous transthoracic needle aspiration. Anterior and apical segmentectomy was carried out and the lesion was pathologically diagnosed as sclerosing hemangioma of lung.

Roxithromycin 으로 치료 후 호전을 보인 미만성 범세기관지염 1예

어성준,박성우,이준혁,장안수,박춘식 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Diffuse panbronchiolitis is a clinical pathologic condition characterized by chronic inflammation of respiratory bronchioles, with clinical features that position it as a differential diagnosis among the sinopulmonary syndromes. We experienced 46-year-old male patient who complained of dyspnea and productive sputum for 2 years. Diagnosis was made by the clinical and radiological features and confirmed by transbronchial biopsy. The clinical findings included chronic sinusits, productive cough,dyspnea, rhonchi, and wheezes. High resolution computerized tomography showed a diffuse nodular pattern, airway ectasia, and airway wall thickening. The biopsy showed interstitial accumulation of foam cells and lymphoid cells in the walls of respiratory bronchioles. We treated low does of roxithromycin, After 8 months, the patient nearly improved symptoms and HRCT findings.

급성 호흡곤란 증후군으로 발현된 폐결핵 1례

윤여준,박성우,이준혁,장안수,박춘식 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Pulmonary tuberculosis as a cause of the acute respiratory distress syndrome is quite rare. The diagnosis of acute respiratory distress syndrome due to pulmonary tuberculosis is difficult because of the diversity of radiological patterns. The ability to identify patients at risk for the acute respiratory distress syndrome is important if therapies are to be developed to prevent the disorder. We experienced a young female compliants with mild fever, dyspnea who diagnosed pulmonary tuberculosis 1 months ago. She stoped anti-tuberculosis medication 2 day because confirmation of drug fever and after then sudden aggravated dyspnea. The clinical course of this case is similar with presentaion of ARDS. We started antituberculosis medication with steroid, which result in good prognosis.

주물공에서 발생한 Goodpasture증후군 1예

김민기,고동희,이선웅,조민희,유희용,김보연,이준혁 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.1

Background: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results. Case: A 46-year-o1d man, who had worked as a foundry worker for 27 years and had a 12 1/2 pack-year history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomeru-lonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA(0.0106 mg/m³), which was calibrated for overtime. Conclusion: Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure. 배경: 유리규산에 노출되면 말기 신질환의 주요원인인 사구체신염이 증가할뿐만 아니라. 자가면역질환인 Goodpasture 증후군도 발생하는 것으로 보고되어 있다. 저자들은 27년간 주물공으로 근무한 근로자에서 발생한 Goodpasture 증후군이 작업관련성 조사를 통해 유리규산에 의해 발생하였을 가능성이 높다고 판단하였기에 이를 고찰과 함께 보고하는 바이다. 증례: 25년간 반갑씩 흡연을 하였고. 주물공장에서 수동 및 자동조형작업을 27년간 하였다. 내원 2주전부터 발생한 흉통과 기침으로 입원하였으며, 내원 당시 혈뇨, 단백뇨 및 중증의 제한성 폐기능 장애를 보였다. 이후 갑작스럽게 혈액요소질소와 크레아티닌이 증가하였다. 면역검사에서 ANA (+), ANCA (-), Anti-GBM Ab가 36.8 EU/mL(참고치 0∼10 EU/mL)로 양성이었으며, 신조직검사에서 무면역 사구체신염, 기관지내시경에서 출혈이 보여 Goodpasture 증후군으로 진단하고 투석 및 혈장분리 반출술을 시행하였다. 노출평가에서 호흡성분진 중 석영이 0.0793 mg/m³로, 근무시간으로 보정한 노출기준인 0.0106 mg/m³를 초과하였다. 결론: 본 증례는 노출평가와 작업력조사를 통해 유리규산 노출이 확인되었고 다른 전신질환으로 인한 신질환이 아니며 신세뇨관의 기능 이상이 사구체신염보다 먼저 나타난 이유로 유리규산에 노출되어 발생한 Goodpasture 증후군으로 판단된다.

비혈연간 동종 골수이식술 후 발생한 혈전성 미세혈관병증 1례

이국경,배상병,김주성,이준혁,이유경,이규택,박성규,원종호,백승호,진소영,홍대식,박희숙 대한조혈모세포이식학회 2000 대한조혈모세포이식학회지 Vol.5 No.2

혈전성 미세혈관병증은 골수이식 후 발생하는 중한 합병증 중의 하나이다. 저자들은 22세의 급성 림프구성 백혈병(ALL, L3)을 진단 후 비혈연간 동종 골수이식을 받은 환자에서 발생한 혈전성 미세혈관병증을 경험하였다. 그는 비혈연간 동종골수이식술을 받았으며 이식의 전처치로 busulfan, cyclophosphamide, 전신방사선조사를 받았고 이식편대숙주반응을 막기 위하여 CsA와 methotrexate을 투여받았다. 이식 후 28일째 말초혈액도말검사상 Burr cell, schistocyte, tear drop cell이 관찰되었으며, 이식 후 31일째 혈변소견이 보여 S결장 내시경상 장관 이식편대 숙주질환 소견이 보였고 혈청검사상 거대세포바이러스가 양성소견을 보여 steroid와 gancyclovir를 투여받았고 2주 후에 장관 이식편대 숙주반응이 호전되었다. 이식 후 68일째 임상적으로 혈전성 미세혈관병증이 발생되었고 Cr 수치가 증가되어 TPE와 혈액투석을 격일로 시행하였으나 악화되었다. 이식 후 82일째 다발성 출혈로 사망하였다. Thrombotic microangiopathy (TMA) is one of the serious complications of bone marrow transplantation (BMT). We experienced a 22-year-old male with acute lymphoblastic leukemia (ALL, L3) who developed post BMT-TMA. He received pretransplant conditioning chemotherapy with busulfan, cyclophosphamide, and total body irradiation (TBI). He received cyclosporine (CsA) and methotrexate (MTX) for graft versus host disease (GVHD) prophylaxis. Peripheral blood smear revealed burr cells, schistocytes and tear drop cells on post BMT day 28. Hematochezia was developed on post BMT day 31. Biopsy specimen of sigmoid colon revealed grade III to IV acute GVHD and cytomegalovirus (CMV) culture was positive in blood on post BMT day 43. He received steroid pulse therapy and gancyclovir so that improved after 2 weeks. TMA was developed clinically on post BMT day 68 and creatine (Cr) was increased. In spite of undergoing plasma exchange with fresh frozen plasma and hemodialysis every other day, TMA progressed. He died due to multiple hemorrhage on post BMT day 86.

Human glioblastoma arises from subventricular zone cells with low-level driver mutations

Lee, Joo Ho,Lee, Jeong Eun,Kahng, Jee Ye,Kim, Se Hoon,Park, Jun Sung,Yoon, Seon Jin,Um, Ji-Yong,Kim, Woo Kyeong,Lee, June-Koo,Park, Junseong,Kim, Eui Hyun,Lee, Ji-Hyun,Lee, Joon-Hyuk,Chung, Won-Suk,Ju Springer Science and Business Media LLC 2018 Nature Vol.560 No.7717

Diagnostic Yield and False-Referral Rate of Staging Chest CT in Patients with Colon Cancer

Lee, Kyung Hee,Park, Ji Hoon,Kim, Young Hoon,Lee, Kyung Won,Kim, Jin Won,Oh, Heung-Kwon,Jeon, Jong-June,Yoon, Hyuk,Kim, Jihang,Lee, Kyoung Ho Radiological Society of North America 2018 Radiology Vol. No.